Zhang Xia, Lv Lizhi, Wu Zhixian, Li Dongliang, Zhang Kun, Peng Yonghai
Department of Hepatobiliary Disease, The 900th Hospital of The People's Liberation Army Joint Service Support Force (Dongfang Hospital), Xiamen University Fuzhou 350025, Fujian Province, China.
Department of Hepatobiliary Surgery, The 900th Hospital of The People's Liberation Army Joint Service Support Force (Dongfang Hospital), Xiamen University Fuzhou 350025, Fujian Province, China.
Am J Transl Res. 2022 Feb 15;14(2):990-1000. eCollection 2022.
To evaluate the impact of orthotopic liver transplantation (OLT) on postoperative quality of life (QoL), survival rate and recurrence rate of patients with liver cancer (LC).
One hundred and twenty-seven patients with LC treated in our hospital from December 2016 to January 2018 were divided into two groups according to different treatment schemes. Patients in the research group (n=67) were given OLT and those in the control group (n=60 cases) were given hepatectomy. The incidence of postoperative complications, hospitalization expenses, the time to liver function recovery, surgical wound healing, pain resolution and hospitalization were compared between the two groups. The overall survival rate (OSR), disease-free survival rate (DFSR), and average survival time of patients were recorded and compared. The Visual Analogue Scale (VAS) score one day and three days after surgery, alpha-fetoprotein (AFP) level, and adverse emotion before and after operation were compared. QoL scores at six months after surgery, one-year recurrence and metastasis rates, and treatment satisfaction one year after surgery were also compared. The expression of Ki-67 and Topo IIαin the tumor-bearing group (n=5) was detected.
The research group presented markedly lower incidence of postoperative complications, and evidently shorter time to liver function recovery, surgical wound healing, pain resolution and hospitalization, while with noticeably higher hospitalization expenses. The one-year and five-year OSRs and DFSRs were noticeably higher, and the average survival time was remarkably longer in the research group as compared to the control group. Patients in the research group scored remarkably lower in VAS scores on the first and third day after surgery than patients in the control group. In comparison with the control group, the one-year recurrence and metastasis rates were evidently lower in the research group, and the scores of SF-36 were remarkably higher. The AFP level at one month after surgery was obviously lower in the research group, and the treatment satisfaction was greatly higher. Ki-67 in the tumor-bearing group was mainly located in the nucleus, and Topo IIα was mainly nucleus positive; the positive Ki-67 and Topo IIα expression rates in the tumor-bearing group was 66.7% and 69.8%, respectively.
OLT can improve the postoperative QoL, survival rate and reduce the recurrence rate of LC patients.
评估原位肝移植（OLT）对肝癌（LC）患者术后生活质量（QoL）、生存率及复发率的影响。
将2016年12月至2018年1月在我院接受治疗的127例LC患者按不同治疗方案分为两组。研究组（n = 67）接受OLT，对照组（n = 60例）接受肝切除术。比较两组术后并发症发生率、住院费用、肝功能恢复时间、手术切口愈合情况、疼痛缓解情况及住院时间。记录并比较患者的总生存率（OSR）、无病生存率（DFSR）及平均生存时间。比较手术1天及3天后的视觉模拟评分（VAS）、甲胎蛋白（AFP）水平及手术前后的不良情绪。比较术后6个月的QoL评分、1年复发转移率及术后1年的治疗满意度。检测荷瘤组（n = 5）中Ki-67和拓扑异构酶IIα（Topo IIα）的表达。
研究组术后并发症发生率明显较低，肝功能恢复时间、手术切口愈合时间、疼痛缓解时间及住院时间明显较短，但住院费用明显较高。与对照组相比，研究组的1年和5年OSR及DFSR明显更高，平均生存时间明显更长。研究组患者术后第1天和第3天的VAS评分明显低于对照组。与对照组相比，研究组的1年复发转移率明显较低，SF-36评分明显更高。研究组术后1个月的AFP水平明显较低，治疗满意度明显更高。荷瘤组中Ki-67主要位于细胞核，Topo IIα主要为细胞核阳性；荷瘤组中Ki-67和Topo IIα的阳性表达率分别为66.7%和69.8%。
OLT可改善LC患者术后的QoL、生存率并降低复发率。
