肝细胞癌病理特征的预后意义。对278例患者的多因素分析。

Prognostic significance of pathologic features of hepatocellular carcinoma. A multivariate analysis of 278 patients.

作者信息

Ng I O, Lai E C, Fan S T, Ng M M, So M K

机构信息

Department of Pathology, University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong.

出版信息

Cancer. 1995 Dec 15;76(12):2443-8. doi: 10.1002/1097-0142(19951215)76:12<2443::aid-cncr2820761207>3.0.co;2-f.

DOI:10.1002/1097-0142(19951215)76:12<2443::aid-cncr2820761207>3.0.co;2-f

PMID:8625069

Abstract

BACKGROUND

In patients with hepatocellular carcinoma, surgical resection may offer a chance of cure. However, tumor recurrence is not infrequent after resection.

METHODS

To identify the pathologic factors that are of prognostic significance and predictive value in tumor recurrence, the authors studied 278 patients (243 men, 35 women) who had hepatectomy for hepatocellular carcinoma. Disease free and actuarial survival were correlated with 20 pathologic parameters of the resected specimens using multivariate analysis.

RESULTS

The median follow-up period was 23.6 months. The overall disease free survival rates at 1, 3 and 5 years were 42%, 23%, and 17%, respectively, and the overall actuarial survival rates for the corresponding time periods were 70%, 39%, and 28%, respectively. The results indicated that tumor encapsulation (P = 0.004) and heavy intratumor inflammatory infiltrates (P = 0.003) were independent favorable factors related to tumor recurrence. Negative resection margins (P = 0.001) and heavy intratumor inflammatory infiltrates (P = 0.003) were independent favorable factors correlated with survival.

CONCLUSIONS

From this analysis, it was determined that detailed histologic examination of resected specimens of hepatocellular carcinoma is important in assessing long term prognosis and stratification of patients for treatment.

摘要

背景

在肝细胞癌患者中，手术切除可能提供治愈的机会。然而，切除术后肿瘤复发并不罕见。

方法

为了确定对肿瘤复发具有预后意义和预测价值的病理因素，作者研究了278例接受肝细胞癌肝切除术的患者（243例男性，35例女性）。采用多变量分析将无病生存期和实际生存率与切除标本的20项病理参数进行关联。

结果

中位随访期为23.6个月。1年、3年和5年的总体无病生存率分别为42%、23%和17%，相应时间段的总体实际生存率分别为70%、39%和28%。结果表明，肿瘤包膜（P = 0.004）和肿瘤内大量炎性浸润（P = 0.003）是与肿瘤复发相关的独立有利因素。切缘阴性（P = 0.001）和肿瘤内大量炎性浸润（P = 0.003）是与生存相关的独立有利因素。