肝细胞癌术后早期复发转移的影响因素研究

发布时间：2018-11-14 08:21

【摘要】：[目的]本研究旨在探求肝细胞癌切除术后早期复发转移的影响因素,有助于对术后复发危险因素患者进行临床干预,降低术后复发转移率,延长患者无瘤生存期,改善疾病预后。[方法]回顾性分析昆明医科大学第二附属医院肝胆胰外科一区2007年01月01日至2016年1月31日期间行手术切除并经术后病理证实为肝细胞癌共68例患者的病历资料。根据患者是否在1年内复发将其分为1年内复发组(n=33)和1年内未复发组(n=35)。将可能影响HCC患者术后早期复发转移的48项因素纳入研究,对随访结果及收集的临床资料采用SPSS 21.0软件进行统计分析,单因素分析采用:卡方检验、t检验;对有统计学意义的因素再进行二元Logistic多因素回归分析,筛选肝癌术后早期复发转移的独立影响因素。[结果]1.截止到2017年01月31日,共随访72例患者,4例失访,失访率5.56%。2.单因素分析结果显示:肿瘤分化程度、手术时间、脉管癌栓、术前AFP、术后辅助治疗等因素对术后早期复发转移有影响。3.多因素分析显示:肿瘤分化差、手术时间长、术前AFP (400ng/ml)为影响肝癌术后早期复发的独立危险因素,术后辅助治疗为影响肝细胞癌术后早期复发转移的保护性因素。[结论]肿瘤分化差、手术时间长、术前AFP (400ng/ml)为影响肝细胞癌术后早期复发转移的独立危险因素,术后辅助治疗为HCC术后早期复发转移的保护性因素。我们建议术后对具有上述危险因素患者应加强随访,必要时采取辅助治疗措施。
[Abstract]:[objective] to explore the influencing factors of early recurrence and metastasis of hepatocellular carcinoma (HCC) after resection, and to help patients with recurrence and metastasis to carry out clinical intervention, reduce the rate of recurrence and metastasis, and prolong the tumor-free survival of the patients. Improve the prognosis of disease. [methods] the medical records of 68 patients with hepatocellular carcinoma (HCC) confirmed by postoperative pathology from January 01, 2007 to January 31, 2016 in the first region of Department of Hepatobiliary and Pancreatic surgery, second affiliated Hospital of Kunming Medical University, were retrospectively analyzed. According to whether the patient recurred within 1 year, the patients were divided into 1 year recurrence group (nong33) and 1 year non-recurrence group (nf35). 48 factors which may affect the early recurrence and metastasis of HCC patients were included in the study. The follow-up results and clinical data were analyzed by SPSS 21.0 software. The single factor analysis was carried out by chi-square test and t test. The multivariate Logistic regression analysis was used to screen the independent factors of early recurrence and metastasis of liver cancer. [result] 1. By January 31, 2017, a total of 72 patients had been followed up and 4 patients had lost their visits, with a loss rate of 5. 56 and 2. 2. Univariate analysis showed that tumor differentiation, operative time, vascular tumor embolus, preoperative AFP, and postoperative adjuvant therapy had influence on early recurrence and metastasis. Multivariate analysis showed that tumor differentiation was poor, operation time was long, preoperative AFP (400ng/ml) was an independent risk factor for early recurrence of HCC, and postoperative adjuvant therapy was the protective factor affecting early recurrence and metastasis of HCC. [conclusion] AFP (400ng/ml) is an independent risk factor for early recurrence and metastasis of hepatocellular carcinoma (HCC), and adjuvant therapy is the protective factor for early recurrence and metastasis after HCC. We recommend that patients with these risk factors should be followed up and treated with adjuvant treatment if necessary.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R735.7

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