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中国癌症防治杂志

中国癌症防治杂志 ›› 2012, Vol. 4 ›› Issue (1): 57-61.doi: 10.3969/j.issn.1674-5671.2012.01.14

• 临床研究 • 上一篇    下一篇

169例BCLC　B期肝细胞癌切除术预后因素分析

  

  1. 广西医科大学附属肿瘤医院肝胆外科
  • 出版日期:2012-03-25 发布日期:2012-04-16
  • 通讯作者: 向邦德 E-mail:xiangbangde@163.com
  • 基金资助:

    广西自然科学基金资助项目（2011GXNSFA018307）；广西硕士研究生科研创新项目（2011105981002M232）

Analysis of prognostic factors in 169 patients with BCLC stage B hepatocellular carcinoma after hepatectomy

  • Online:2012-03-25 Published:2012-04-16

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摘要： 目的 探讨BCLC B期肝细胞癌（hepatocellular carcinoma，HCC）患者手术切除预后的影响因素。方法 收集2003年3月至2007年9月169例BCLC B期HCC手术切除患者的临床病理资料，采用Kaplan-Meier法计算术后累积生存率，以Log-rank显著性检验初步筛选出可能影响HCC预后的相关因素，应用Cox回归分析进一步明确影响预后的独立因素。结果 BCLC B期HCC患者术后1、3、5年累积生存率分别为76.3%、46.0%、38.8%。单因素分析表明术前谷丙转氨酶（ALT）、肿瘤包膜、肿瘤数目、肝硬化和术后辅助治疗影响HCC术后累计生存率（P＜0.05）。多因素分析表明肿瘤包膜、肿瘤数目、肝硬化和术后辅助治疗是影响HCC术后生存率的独立因素（P＜0.05）。结论 手术切除是BCLC B期HCC患者有效的治疗手段，肿瘤包膜、肿瘤数目、肝硬化和术后辅助治疗是其预后的独立影响因素。

关键词: 肝细胞癌, 肝切除术, 生存率, 预后

Abstract: Objective To investigate prognostic factors affecting the outcomes of patients with Barcelona Clinic Liver Cancer （BCLC） stage B hepatocellular carcinoma（HCC） after hepatectomy. Methods Clinicopathologic data of 169 patients with BCLC stage B HCC were analyzed retrospectively.All patients underwent hepatectomy between March 2003 and September 2007.Cumulative survival rates were calculated by the Kaplan-Meier method.Prognostic factors were screened initially by the log-rank test，and indepen-dent prognostic factors were further analyzed by Cox regression.Results Overall survival rates for 1，3，and 5 years were，respec-tively，76.3%，46.0%，and 38.8%.According to the log-rank test，preoperative serum ALT （P=0.029），tumor capsule （P=0.031），tumor number （P=0.026），liver cirrhosis （P=0.027），and postoperative adjuvant therapy （P<0.001） were significantly associated with prognosis of stage B HCC，and Cox regression indicated that independent prognostic factors were tumor capsule （P=0.032），tumor number （P=0.048），liver cirrhosis （P=0.049），and postoperative adjuvant therapy （P<0.001）.Conclusions Hepatectomy is an effective therapy in patients with stage B HCC，and tumor capsule，tumor number，liver cirrhosis，and postoperative adjuvant therapy are independent prognostic factors.

Key words: Hepatocellular carcinoma, Hepatectomy, Survival rates, Prognosis