【摘要】 目的:探讨影响原发性肝细胞性肝癌(hepatocellular carcinoma,HCC)术后复发的因素,为术中术后治疗及判断预后提供依证据。方法:回顾分析1998年1月～2005年6月,我院94例HCC术后复发病例的临床和病理资料,将病人分为近期复发(≤2年)和远期复发(>2年)两组,分析比较两组患者的性别、年龄、初诊症状、HBsAg、肝功能Child分级、AFP值、肝硬化、肿瘤病灶、肿瘤大小、肿瘤包膜、血管侵犯和转移、手术切缘、病理分级、术后综合治疗、再次手术和术中出血量等在近远期复发有无差异。结果:肝癌术后2年内和2年后复发在肿瘤大小、肿瘤包膜、血管侵犯和转移、手术切缘、术中出血量、术后综合治疗以及再次手术的差异有统计学意义,是复发的危险因素;而在性别、年龄、初诊症状、HBsAg,肝硬化、肝功能Child分级、AFP值、肿瘤病灶和病理分级上的差异无统计学意义。结论:影响HCC肝切除术后近期和远期复发的临床和病理因素可能不同,早期发现肝癌,规范的手术切除,减少手术出血量,术后复发采取综合治疗是改善患者预后的重要措施。更多还原

【Abstract】 Objective:To explore the influencing factors of the recurrence for hepatocellular carcinoma(HCC) after surgery and provide evidence for treatment and judgement prognosis during operation and post-operation.Methods:A retrospective survey about clinical pathological data was carried out in 94 recurrent patients with HCC underwent hepatectomy between Jan 1998 and Jun 2005.All the patients were divided into two follow-up groups,like early(<2 years) and late(>2 years) recurrence groups and statistical analysis was done to evaluate the influence of sex,age,preliminary diagnosis symptom,HBsAg,Child grade,AFP,liver cirrhosis,tumor lesion,tumor size,tumor capsule,invasion,metastasis,resection margin,pathological grade,combined therapy,reoperation and bleeding volume during operation.Results:The recurrent patients within and after 2 years showed statistical differences on tumor size,tumor capsule,invasion,metastasis,resection margin,bleeding volume during operation,combined therapy and reoperation,the remained factors have not seen differences significantly.Conclusion:Clinical pathological factors of the short-term and long-term recurrence may be different,early diagnosis,standard hepatectomy,less bleeding loss and comprehensive treatment after operation may be crucial to improve prognosis.更多还原