【摘要】 目的评价肝癌患者肝内微小静脉浸润在外科治疗中的意义。方法回顾性分析305例行肝癌切除术患者的临床和病理资料,根据肿瘤病理特点,分为镜下微小静脉浸润组、肉眼静脉浸润组、无静脉浸润组,分析各组的生存率,多因素分析肝癌微小静脉浸润对术后生存的影响。结果微小静脉浸润组132例(43．2%),肉眼静脉浸润组70例(23．0%),无静脉浸润组103例(33．8%),肉眼静脉浸润组的标本全部伴有镜下微小静脉浸润,本组微静脉浸润者202例(66．2%)。瘤体越大,静脉浸润的概率越大。微静脉浸润组中位生存时间29．4个月,术后1、3、5年累积生存率分别是63．6%、38．6%、25．8%；肉眼静脉浸润组中位生存时间9．4个月,术后1、3、5年累积生存率分别是35．7%、11．4%、4．3%；无静脉浸润组中位生存时间48．4个月,术后1、3、5年累积生存率分别是85．4%、59．2%、48．5%。Cox回归分析示,微静脉浸润、肉眼静脉浸润、肿瘤大小及数目、手术切缘是影响肝癌患者术后生存的重要因素,微静脉浸润的相对危险度(HR)是1．926。结论肝癌肝内微小静脉浸润是肿瘤恶性进展的关键阶段,也是影响术后生存的重要因素。更多还原

【Abstract】 Objective To evaluate the significance of microscopic tumor venous invasion in hepatocellular carcinoma(HCC) patients after resection. Methods Three hundred and five resected HCC patients were divided into three groups (microscopic venous invasion, macroscopic venous invasion and no venous invasion) according to the histopathology. Survival rate was evaluated and the effect of microscopic venous invasion on postoperative patient survival was studied by multivariate analysis. Results There were 132 patients (43.2%) with microinvasion, 70 patients (23.0%) with macroinvasion, and 103 patients (33. 8%) without venous invasion. The larger the tumor, the higher the incidence of microscopic and macroscopic invasion. For microscopic invasion group, mean survival time was 29.4 months, the postoperative 1-,3-,5-year cumulative survival rate was 63.6%, 38, 6%, and 25.8% respectively, while mean survival time was 9. 4 months and 1-, 3-, 5-year survival rate was 35. 7%, 11.4%, and 4. 3% respectively for macroscopic invasion group. The mean survival time was 48.4 months and 1-, 3-, 5-year survival rate was 85.45%, 59.2%, and 48. 5% respectively for no invasion group. Cox regression multivariate analysis indicated microscopic and macroscopic venous invasion, tumor size and number, surgical margin were significant predictors of postoperative survival. The hazard ratio (HR) of microscopic invasion was 1. 926. Conclusions In HCC patients, microscopic tumor venous invasion is frequently seen. It is a significant negative predictor of postoperative survival.更多还原