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影响肝癌根治性切除术后早期复发的因素。

Factors influencing early recurrence of hepatocellular carcinoma after curative resection.

机构信息

Department of Hepatopancreatobiliary Surgery, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, Zhejiang, P.R. China.

Department of Liver Surgery, The First Affiliated Hospital of USTC, Hefei, Anhui, P.R. China.

出版信息

J Int Med Res. 2020 Aug;48(8):300060520945552. doi: 10.1177/0300060520945552.

Abstract

OBJECTIVE

To identify the factors influencing early recurrence in patients with hepatocellular carcinoma (HCC) after curative resection.

METHODS

Clinical data for 99 patients with HCC undergoing curative resection were analyzed. The clinicopathological factors influencing early recurrence were analyzed by Cox regression.

RESULTS

Twenty-five of 99 patients (25.3%) suffered from early recurrence. There were significant differences between patients with and without recurrence in terms of tumor diameter, tumor capsular integrity, and preoperative alpha fetoprotein level. Cox regression analysis revealed that a tumor diameter >2.6 cm and preoperatively increased total bilirubin (TBL) level were risk factors for postoperative recurrence, while tumor capsular integrity had a protective effect on postoperative recurrence. After adjusting for preoperative TBL level and tumor capsular integrity, the risk of HCC recurrence was markedly increased in line with increasing tumor diameter in a non-linear manner.

CONCLUSION

Tumor diameter >2.6 cm and preoperatively increased TBL level are associated with a higher risk of early recurrence after curative resection in patients with HCC, while tumor capsular integrity is associated with a lower risk of early recurrence.

摘要

目的

确定影响肝细胞癌(HCC)患者根治性切除术后早期复发的因素。

方法

分析 99 例行根治性切除术的 HCC 患者的临床病理资料。采用 Cox 回归分析影响早期复发的临床病理因素。

结果

99 例患者中有 25 例(25.3%)发生早期复发。复发组与无复发组在肿瘤直径、肿瘤包膜完整性和术前甲胎蛋白水平方面存在显著差异。Cox 回归分析显示,肿瘤直径>2.6cm 和术前总胆红素(TBL)水平升高是术后复发的危险因素,而肿瘤包膜完整性对术后复发有保护作用。在校正术前 TBL 水平和肿瘤包膜完整性后,HCC 复发的风险随着肿瘤直径的增加呈非线性显著增加。

结论

肿瘤直径>2.6cm 和术前 TBL 水平升高与 HCC 患者根治性切除术后早期复发风险增加相关,而肿瘤包膜完整性与早期复发风险降低相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a82f/7780562/d30b256af552/10.1177_0300060520945552-fig1.jpg

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