Maeda Takashi, Shimada Mitsuo, Harimoto Norifumi, Tsujita Eiji, Aishima Shin-ichi, Tanaka Shinji, Shirabe Ken, Maehara Yoshihiko
Department of Surgery and Science, Graduate School of Medical Sciences Kyushu University, Fukuoka, Japan.
Hepatogastroenterology. 2008 Jul-Aug;55(85):1428-32.
BACKGROUND/AIMS: Clinicopathologic characteristics and postoperative prognosis of early hepatocellular carcinoma (eHCC) have not been clarified.
Early HCC was designated as tumor purely composed of well-differentiated HCC not containing moderately or poorly differentiated component. Twenty seven patients with early HCC among 515 patients underwent hepatic resection for HCC were analyzed.
The survival rate at 5 years after hepatic resection of the patients with early HCC was 76%. No clinicopathologic factors correlated with the survival. The postoperative recurrence occurred in 19 (70%) patients, and nine patients survived more than five years free of recurrence. The levels of aspartate aminotransferase and alanine aminotransferase of the patients with recurrence within five years (n = 9) were much higher than those of the patients without recurrence (n = 18). The prognosis after recurrence of the patients with more than three tumors was significantly worse than that of the patients with one or two tumors (P < 0.01).
The survival rate of early HCC after hepatic resection is favorable, however, recurrence is considerably frequent and it depends on the degree of inflammation of underling liver disease. Therefore, the control of inflammation of liver parenchyma and the preservation of liver function may be most important in patients with early HCC.
背景/目的：早期肝细胞癌（eHCC）的临床病理特征及术后预后尚未明确。
早期肝癌定义为肿瘤仅由高分化肝癌组成，不包含中分化或低分化成分。对515例行肝癌肝切除术的患者中的27例早期肝癌患者进行分析。
早期肝癌患者肝切除术后5年生存率为76%。无临床病理因素与生存率相关。19例（70%）患者术后复发，9例患者无复发存活超过5年。5年内复发患者（n = 9）的天冬氨酸转氨酶和丙氨酸转氨酶水平显著高于未复发患者（n = 18）。肿瘤多于3个的患者复发后的预后明显差于肿瘤为1个或2个的患者（P < 0.01）。
早期肝癌肝切除术后生存率良好，但复发相当频繁，且取决于潜在肝脏疾病的炎症程度。因此，对于早期肝癌患者，控制肝实质炎症和保护肝功能可能最为重要。
