Transplant Center, University of Kentucky College of Medicine, 800 Rose Street, Lexington, KY 40536, USA.
HPB (Oxford). 2010 Feb;12(1):56-61. doi: 10.1111/j.1477-2574.2009.00128.x.
To determine factors associated with outcomes and microvascular invasion (MVI) in patients undergoing liver transplantation (LT) for hepatocellular carcinoma (HCC).
Between July 1996 and August 2008 at the Universities of Kentucky or Tennessee, LT recipients were retrospectively analysed.
One hundred and one patients had HCC in the explanted liver; one patient was excluded because of fibrolamellar histology. Seventy-nine (79%) were male and 81 (81%) were older than 50. HCC was incidental in 32 patients (32%). Median follow-up was 31 months. Ten patients (10%) developed recurrence, which was associated with poor survival (P= 0.006). Overall 1-, 3-, and 5-year survival rates were 87%, 69% and 62%, respectively. Excluding patients with lymph node metastasis (LNM) or MVI yielded 91%, 81% and 75% survival at the same time points. MVI was independently associated with recurrence (OR 28.40, 95% CI 1.77-456.48, P= 0.018) and decreased survival (OR 4.70, 95% CI 1.24-17.80, P= 0.023), and LNM with decreased survival (OR 6.05, 95% CI 1.23-29.71, P= 0.027). Tumour size (OR 4.1, 95% CI 1.2-13.5, P= 0.013) and alpha-fetoprotein (AFP) > 100 (OR 5.0, 95% CI 1.4-18.1, P= 0.006) were associated with MVI.
MVI greatly increases the risk of recurrence and death after LT for HCC, and is strongly associated with tumour size and AFP > 100.
为了确定与接受肝癌肝移植（LT）治疗的患者结局和微血管侵犯（MVI）相关的因素。
1996 年 7 月至 2008 年 8 月期间，肯塔基大学或田纳西大学对 LT 受者进行了回顾性分析。
在切除的肝脏中，101 例患者患有 HCC，1 例因纤维板层组织学而被排除。79 例（79%）为男性，81 例（81%）年龄大于 50 岁。32 例（32%）为偶然发现的 HCC。中位随访时间为 31 个月。10 例（10%）患者发生复发，与生存不良相关（P=0.006）。总体而言，1、3 和 5 年生存率分别为 87%、69%和 62%。同时排除淋巴结转移（LNM）或 MVI 患者的生存率分别为 91%、81%和 75%。MVI 与复发（OR 28.40，95%CI 1.77-456.48，P=0.018）和生存降低（OR 4.70，95%CI 1.24-17.80，P=0.023）独立相关，LNM 与生存降低相关（OR 6.05，95%CI 1.23-29.71，P=0.027）。肿瘤大小（OR 4.1，95%CI 1.2-13.5，P=0.013）和 AFP>100（OR 5.0，95%CI 1.4-18.1，P=0.006）与 MVI 相关。
MVI 极大地增加了 HCC 患者 LT 后复发和死亡的风险，与肿瘤大小和 AFP>100 密切相关。
