摘要
目的探讨影响肝细胞癌根治性切除术后预后的相关因素，为肝细胞癌的术后综合治疗及判断预后提供依据。方法回顾性分析194例肝细胞癌的临床病理资料，对潜在的可能影响术后预后的临床病理因素进行单因素分析，将单因素分析后有统计学意义的因素带人Cox比例风险回归模型进行多因素分析。结果全组患者的术后1、3、5年的累积生存率分别为81．4％、50．6％、33．9％。单因素分析结果显示：术前AST、ALP、GGT、肿瘤最大直径、肿瘤病灶数目、手术持续时间、手术中总失血量、手术中输血情况、术后2年内复发是有统计学意义的因素。Cox模型多因素分析结果示术后2年内复发、术前AST浓度是有统计学意义的因素。结论HCC根治性切除术后的预后取决于多种因素的共同作用，术后2年内复发、术前AST浓度是影响术后预后的最重要因素。
Objective To explore the factors influencing prognosis of hepatocellular carcinoma after curative hepatectomy to provide the evidence for postoperative comprehensive therapy and the judgment of prognosis. Methods The clinical and pathologic data of 194 patients receiving curative hepatectomy of HCC from January 2001 to January 2005 were retrospectively analyzed. The univariate analysis was performed to determine the potentially possible prognostic factors. By introducing these factors which had been identified to be positive in univariate analysis into the Cox proportional hazard regression model, multivariate analysis was carried out. Results The cumulative survival rate of 1,3,5 years in patients with HCC after curative hepatectomy was 81.4% ,50. 6% and 33. 9% , respectively. The univariate analysis showed that preoperative AST level, preoperative ALP level, preoperative GGT level, tumor maximum diameter, number of tumor nodules, operation persistence time,bleeding volume during operation, perioperative blood transfusion and tumor postoperative recurrence within two years were the factors which had statistically significance. The Cox model multivariate analysis indicated that tumor postoperative recurrence within two years and preoperative AST level were the factors which had statistically significance. Conclusion The prognosis of patients with HCC after curative hepatectomy is depended on the common effect of multiple factors. Tumor postoperative recurrence within two years and preoperative AST level were the most significant factors influencing postoperative prognosis.
出处
《中国临床实用医学》
2008年第3期18-19,共2页
China Clinical Practical Medicine
关键词
肝细胞癌
肝切除术
预后
COX比例风险回归模型
Hepatoceilular carcinoma
Hepatectomy
Prognosis
Cox proportional hazard regression model
