Kwon Soon-Keun, Yun Sung-Su, Kim Hong-Jin, Lee Dong-Shik
Department of Surgery, Yeungnam University College of Medicine, Daegu, Korea.
Ann Surg Treat Res. 2014 Jun;86(6):283-8. doi: 10.4174/astr.2014.86.6.283. Epub 2014 May 23.
Early recurrence after hepatectomy is a well-known poor prognostic factor in patients with hepatocellular carcinoma. This study was undertaken to identify the risk factors of early recurrence in patients with hepatocellular carcinoma after hepatectomy.
One hundred and sixty-seven patients that underwent hepatectomy for hepatocellular carcinoma from January 2005 to December 2010 were enrolled. The numbers of patients with or without early recurrence group were 40 and 127, respectively. Clinico-pathologic factors were retrospectively analyzed.
Potential risk factors were classified as host, tumor, or surgical factors. Of the host factors examined, lobular hepatitis activity was found to be a significant risk factor of early recurrence, and of the tumor factors, infiltrative type of gross appearance, level of preoperative AFP and worst Edmondson-Steiner grade were significant.
The present study shows that an infiltrative gross appearance, a high preoperative AFP level, high lobular hepatitis activity, and a poor Edmondson-Steiner grade are independent risk factors of early recurrence. Accordingly, patients with these risk factors should be followed closely after hepatectomy.
肝切除术后早期复发是肝细胞癌患者公认的不良预后因素。本研究旨在确定肝细胞癌患者肝切除术后早期复发的危险因素。
纳入2005年1月至2010年12月期间因肝细胞癌接受肝切除术的167例患者。早期复发组和无早期复发组的患者人数分别为40例和127例。对临床病理因素进行回顾性分析。
潜在危险因素分为宿主、肿瘤或手术因素。在检查的宿主因素中，小叶性肝炎活动度被发现是早期复发的一个重要危险因素，在肿瘤因素中，大体外观浸润型、术前甲胎蛋白水平和最差的埃德蒙森-斯坦纳分级是显著的。
本研究表明，大体外观浸润型、术前甲胎蛋白水平高、小叶性肝炎活动度高和埃德蒙森-斯坦纳分级差是早期复发的独立危险因素。因此，有这些危险因素的患者在肝切除术后应密切随访。
