包膜形成是大肝癌患者获得较好预后的一个重要预测因素。
Encapsulation is a significant prognostic factor for better outcome in large hepatocellular carcinoma.
机构信息
Department of General Surgery, Chang Gung Memorial Hospital, Linkou, Chang Gung University Medical School, Taoyuan, Taiwan.
出版信息
J Surg Oncol. 2012 Jan;105(1):85-90. doi: 10.1002/jso.22060.
BACKGROUND
The aim of this study was to determine the effect of tumor encapsulation of hepatocellular carcinoma (HCC) on long-term survival.
METHODS
A retrospective review of 1,240 patients who underwent hepatectomy from January 1993 to June 2005 was conducted. There were 891 patients with tumor encapsulation (EC type) and 349 patients without tumor encapsulation (NC type). Clinicopathological factors, surgical outcome, and long-term survival were analyzed.
RESULTS
Disease-free survival (DFS) was affected by surgical margin involvement, the presence of surgical complications, vascular invasion, liver cirrhosis, tumor encapsulation, tumor size >5 cm, tumor rupture, and the presence of satellite lesions (all, P < 0.05). Overall survival (OS) was also affected by the same parameters, except for satellite lesions. When the patients were grouped by tumor size >5 or ≤5 cm, the protective effect of encapsulation was only observed when the tumor size was >5 cm [odds ratio (OR) for DFS = 0.75, P = 0.02; OR for OS = 0.68, P < 0.01].
CONCLUSIONS
Tumor encapsulation is a significant prognostic factor for HCC >5 cm.
背景
本研究旨在确定肝癌（HCC）肿瘤包膜对长期生存的影响。
方法
回顾性分析了 1993 年 1 月至 2005 年 6 月期间接受肝切除术的 1240 例患者。其中 891 例有肿瘤包膜（EC 型），349 例无肿瘤包膜（NC 型）。分析了临床病理因素、手术结果和长期生存情况。
结果
无病生存率（DFS）受手术切缘受累、手术并发症、血管侵犯、肝硬化、肿瘤包膜、肿瘤大小>5cm、肿瘤破裂和卫星病变的影响（均 P<0.05）。总生存率（OS）也受到同样的参数影响，除了卫星病变。当根据肿瘤大小>5cm 或≤5cm 对患者进行分组时，包膜的保护作用仅在肿瘤大小>5cm 时观察到[DFS 的优势比（OR）=0.75，P=0.02；OS 的 OR=0.68，P<0.01]。
结论
肿瘤包膜是 HCC>5cm 的一个重要预后因素。
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