摘要
目的探讨男女性肝细胞癌患者围手术期转归、术后复发和生存情况的差异。方法采用回顾性病例配对研究，按照年龄、慢性肝炎、肝功能分级、肿瘤直径、分化程度、卫星结节及切缘情况等配对条件，对40例女性术后肝癌患者与同期手术的男性肝癌患者行1：1配对，比较男女性患者的预后情况。结果80例患者均顺利完成手术，男女性肝癌患者的手术时间、术中失血量、血流阻断方法和输血情况比较，差异均无统计学意义（均P〉0．05）。术后第3、7天男女性患者的丙氨酸氨基转移酶、γ-谷氨酰转肽酶和白蛋白水平比较，差异均无统计学意义（均P〉0．05）。术后第3天男女性患者的总胆红素水平差异有统计学意义（P=0．001）。女性患者的1、3、5年无复发生存率分别为76．7％、47．4％和29．7％，男性患者分别为63．8％、30．0％和25．O％，差异无统计学意义（P=0．12）。女性患者的1、3、5年总体生存率分别为92．2％、81．5％和55．4％，男性患者分别为97．4％、55．2％和39．0％，差异有统计学意义（P=0．04）。结论肝细胞癌术后患者的生存情况可能存在性别差异，女性对肝损害有较低的易感性。
Objective Hepatocellular carcinoma （HCC） is sexually dimorphic, with a significantly higher incidence in male. But it is not clear whether the women have a better prognosis than the men. The present study aimed to compare the short and long-term outcomes, postoperative recurrence and survival in female and male patients with HCC after hepatectomy. Methods Clinicopathological data of retrospective analysis was performed on 40 female and matched 40 male HCC patients treated by hepatectomy in Cancer Hospital of Chinese Academy of Medical Sciences between May 2006 and May 2012 were retrospectively reviewed in this study. Patients were paired in terms of age, chronic hepatitis, Child-Pugh class, tumor size, histological differentiation, presence of satellite nodules and resection margin. Results Hepatectomy was successfully performed in all 80 cases. There was no significant difference in intraoperative variables and postoperative outcomes between the female and male groups except the level of total bilirubin. The 1-, 3- and 5-year recurrence-free survival rates were 76.7%, 47.4% and 29.7% in the female group and 63.8%, 30.0% and 25.0% in the male group （P = 0.12）. Corresponding overall survival rates were 92.2% , 81.5% and 55.4% in the female group and 97.4% , 55.2% and 39.0% in the male group （P = 0. 04）. Conclusion Certain gender differences might exist in HCC patients after hepatecomy, favoring females in the overall survival and the tolerance for liver injury.
出处
《中华肿瘤杂志》
CAS
CSCD
北大核心
2014年第4期303-308,共6页
Chinese Journal of Oncology
关键词
癌
肝细胞
肝切除术
预后
性别因素
Carcinoma, Hepatic cell
Hepatectomy
Prognosis
Sex factors
