Fu Xu, Mao Liang, Tang Min, Yan Xiaopeng, Qiu Yudong, He Jian, Zhou Tie
Department of Hepatopancreatobiliary Surgery, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, China.
Department of Radiology, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, China.
Hepatol Res. 2016 Apr;46(4):298-305. doi: 10.1111/hepr.12540. Epub 2015 Jul 2.
The prognostic significance of the gross classification of hepatocellular carcinoma (HCC) has been confirmed in both hepatectomy and living donor liver transplantation. However, the role of this type of classification in HCC treated with radiofrequency ablation (RFA) has rarely been reported. The aim of this study was to investigate the role of preoperative gross classification in cases of solitary small HCC treated with RFA.
From January 2007 to September 2013, 103 patients with solitary small HCC treated with RFA were retrospectively reviewed. The lesions were classified into three types according to gross appearance in preoperative contrast-enhanced computed tomography (CT) scans. Clinicopathological variables and survival information were compared among these three types. Univariate and multivariate analyses were performed to clarify the long-term prognostic factors.
The group of 103 tumors comprised 34 type 1, 49 type 2 and 20 type 3 tumors. The level of preoperative serum α-fetoprotein in the type 3 tumors was significantly higher than that in types 1 and 2 (P < 0.05). The overall survival of the patients with type 3 HCC was the poorest among the three types. The tumor-free survival of the patients with types 3 and 2 HCC were significantly poorer than those with type 1 (P < 0.05). The univariate analysis showed that gross classification, α-fetoprotein level, tumor size and degree of enhancement were poor prognostic factors. The multivariate analysis indicated that the gross classification was the only independent prognostic indicator.
The preoperative gross classification was of great prognostic significance in solitary small HCC treated with RFA.
肝细胞癌（HCC）的大体分类在肝切除术和活体肝移植中均已证实具有预后意义。然而，这种分类在接受射频消融（RFA）治疗的HCC中的作用鲜有报道。本研究旨在探讨术前大体分类在接受RFA治疗的孤立性小HCC病例中的作用。
回顾性分析2007年1月至2013年9月接受RFA治疗的103例孤立性小HCC患者。根据术前增强CT扫描的大体表现将病变分为三种类型。比较这三种类型的临床病理变量和生存信息。进行单因素和多因素分析以明确长期预后因素。
103个肿瘤组包括34个1型、49个2型和20个3型肿瘤。3型肿瘤术前血清甲胎蛋白水平显著高于1型和2型（P<0.05）。3型HCC患者的总生存期在三种类型中最差。2型和3型HCC患者的无瘤生存期显著低于1型（P<0.05）。单因素分析显示大体分类、甲胎蛋白水平、肿瘤大小和强化程度是不良预后因素。多因素分析表明大体分类是唯一的独立预后指标。
术前大体分类在接受RFA治疗的孤立性小HCC中具有重要的预后意义。
