343例肝细胞癌患者手术治疗后生存率及预后影响因素分析

发布时间：2018-12-30 19:17

【摘要】：目的:本文通过回顾性研究343例肝细胞癌行肝切除术患者的生存率,探讨影响肝细胞癌手术治疗预后的相关因素。方法:回顾性分析自2011年1月至2014年12月期间在河北医科大学第四医院肝胆外科行肝切除术治疗的肝细胞癌患者343例,选取可能对肝细胞癌手术预后有影响的因素,包括患者的性别、年龄、乙肝表面抗原(HBsAg)、丙肝抗体、肝硬化、术前AFP水平、术前ALT水平、Child-Pugh分级、肿瘤大小、肿瘤数目、病理脉管癌栓、术中有无输血、TNM分期、BCLC分期等14个分析因素,通过电话随访、门诊复查等方式,获得患者是否死亡、死亡时间等信息。所有数据均采用SPSS 17.0软件进行统计学分析。计数资料采用χ~2检验,计量资料采用t检验,采用Kaplan-Meier生存分析法比较生存率,单因素分析懫用Log-rank检验,多因素分析采用Cox回归分析,P0.05为差异有统计学意义。结果:所有343例患者中,存活病例226例(65.9%),死亡病例117例(34.1%),术后1、3、5年的总体生存率分别为86.3%、64.1%、54.8%。单因素分析结果显示术前AFP水平(P=0.000)、肿瘤大小(P=0.000)、病理脉管癌栓(P=0.000)、TNM分期(P=0.000)及BCLC分期(P=0.000)是肝细胞癌患者手术治疗预后的重要影响因素。Cox模型多因素分析结果示术前AFP水平(P=0.003)、肿瘤大小(P=0.012)、BCLC分期(P=0.011)为影响本组肝细胞患者手术治疗预后的独立危险因素。结论:AFP水平、肿瘤大小、病理脉管癌栓、TNM分期及BCLC分期是影响肝细胞癌手术治疗预后的重要因素。AFP水平、肿瘤大小、BCLC分期是影响肝细胞癌手术治疗预后的独立危险因素。
[Abstract]:Objective: to study the survival rate of 343 patients with hepatocellular carcinoma (HCC) undergoing hepatectomy. Methods: 343 patients with hepatocellular carcinoma treated by hepatectomy in the fourth Hospital of Hebei Medical University from January 2011 to December 2014 were analyzed retrospectively. The factors that might influence the prognosis of HCC were selected. Including sex, age, hepatitis B surface antigen (HBsAg), hepatitis C antibody, liver cirrhosis, preoperative AFP level, preoperative ALT level, Child-Pugh grade, tumor size, tumor number, pathological vascular cancer thrombus, intraoperative blood transfusion, TNM staging. There were 14 analysis factors such as BCLC stage and so on. The information of death and time of death were obtained by telephone follow-up and outpatient reexamination. All the data were analyzed by SPSS 17.0 software. The count data were analyzed by 蠂 ~ 2 test, the measurement data by t test, the survival rate by Kaplan-Meier survival method, the single factor analysis by Log-rank test, the multivariate analysis by Cox regression analysis, the difference was statistically significant (P0.05). Results: of 343 patients, 226 (65.9%) survived and 117 (34.1%) died. The overall survival rate was 86.3% and 54.8% respectively. Univariate analysis showed preoperative AFP level (P0. 000), tumor size (P0. 000), pathological vessel tumor thrombus (P0. 000). TNM stage (P0. 000) and BCLC stage (P0. 000) were important factors in prognosis of patients with hepatocellular carcinoma. Multivariate analysis of Cox model showed that preoperative AFP level (P0. 003) and tumor size (P0. 012). BCLC staging (P0. 011) was an independent risk factor for the prognosis of patients with hepatocellular carcinoma. Conclusion: AFP level, tumor size, pathological vascular tumor embolus, TNM staging and BCLC staging are important factors affecting the prognosis of HCC. BCLC staging is an independent risk factor for the prognosis of hepatocellular carcinoma.
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R735.7

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