【摘要】 目的对不同的原发性肝细胞癌(肝癌)肝移植适应证标准进行评价与验证。方法 2001年至2007年上海七家肝移植中心施行的肝癌肝移植病例共948例,采用Kaplan-Meier法分析符合米兰标准、加利福尼亚标准和上海复旦标准的肝癌肝移植患者的术后4年总体生存率及无复发生存率,并作比较。结果符合米兰标准(369例)、加利福尼亚标准(470例)和上海复旦标准(554例)的患者的术后4年总体生存率及无复发生存率分别为65.8%和74.1%、66.0%和73.6%、63.9%和70.4%。三种标准的总体生存率及无复发生存率比较差异无统计学意义(均为P>0.05)。与符合米兰标准的病例相比,超出米兰标准但符合上海复旦标准的185例,其术后4年生存率及无复发生存率分别为61.5%、65.0%,比较差异亦无统计学意义(均为P>0.05)。结论上海复旦标准适度扩大了肝癌肝移植适应证范围且生存率满意,可能更符合中国国情。更多还原

【Abstract】 Objective To evaluate current selection criteria of liver transplantation(LT) for hepatocellular carcinoma(HCC) and validate it’s clinical value.Methods We evaluated the outcome of 948 consecutive patients with HCC who underwent LT over a 6-year period at Shanghai multi-center collaborative LT group in 7 hospitals.The Kaplan-Meier method with log rank test was used to evaluate survival rate according to different criteria.Results The 4-year overall survival(OS) rate and relapse-free survival(RFS) rate were: Milan criteria(n=369;65.8%,74.1%);UCSF criteria(n=470;66.0%,73.6%);Shanghai Fudan criteria(n=554;63.9%,70.4%);There was no significant difference among these three groups(P>0.05).Compared with Milan criteria group,the patients beyond-Milan-within-Shanghai Fudan criteria(n=185) had similar 4-year OS and RFS(61.5%,65.0%,P>0.05).Conclusion The Shanghai Fudan criteria modestly expands current criteria while still preserving similar survival.更多还原