小肝癌术后早期复发转移临床危险因素分析

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1、小肝癌术后早期复发转移临床危险因素分析仲杨I,刘景丰I,黄尧I,黄新辉I,王先明I,曾金华I,曾永毅I【摘要】目的：探讨原发性小肝癌术后早期复发转移的危险因素，为预测和预防小肝癌术后早期复发转移提供理论依据。方法:冋顾性分析2008年〜2011年行根治性切除的单发R直径W5cm的小肝癌患者屮术后早期复发传移和晚期复发转移的临床病理特征，用单因素和多因素分析小肝癌早期复发转移的危险因索。结果：单因索分析显示小肝癌术后早期复发组和晚期复发组间肿瘤冇无包膜(P=0.027)、术后TBIL峰值(P=0.034)、镜下脉管癌栓(*0.036)有显著性差异；多因素分析提示肿瘤有无包膜是小肝癌术后早期复发

2、的独立危险因素。结论：小肝癌复发时间可能与肿瘤有无包膜，术后TBIL峰值和镜下脉管癌栓等因素冇关，而肿瘤有无包膜是小肝癌术后早期复发的独立危险因素，需加强此类患者术后的监测，并进行提前干预。【关键词】肝细胞癌；复发；转移；危险因素中图分类号：R657.3AnalysisofClinicalRiskFactorsforEarlyRecurrenceandMetastasisofSmallHepatocelluarCarcinomaafterCurativeHepaticResectionZHONGYangLIUJing-feng1,HUANGYao1,HUANGXin-hui1,WANGXi

3、an-ming1,ZENGJin-hua1,ZENGYong-yi1,1SurgicalDepartmentofLiverDiseaseCenterofTheFirstAffiliatedHospitalofFujianMedicalUniversity,FujianScienceResearchCenterofLiverDiseases,Fuzhou350005,Fujian,China.Correspondingauthor：LIUJing-feng,E-mail:drjingfeng@ycihoo.com.cn[Abstract]Objective:Toinvestigatetheri

4、skfactorsforearlyrecurrenceandmetastasisofsmallhepatocellularcarcinomaaftercurativehepaticresection,andtoprovideatheoreticalbasisforthepredictionandpreventionofearlyrecurrenceandmetastasisofsmallhepatocellularcarcinoma・Methods:Thehepatocelluarcarcinomapatientswhoselesionwassingleandlesiondiameterwa

5、slessthan5cmwereinvestigatedretrospectivelyaftercurativehepaticresectionbetween2008and2011.Univariateandmultivariatelogisticregressionanalysiswereperformedaccordingtotherelevantclinicalandpathologyfactorsofearlyandlaterecurrencepatientstoanalysisofriskfactorsforearlyrecurrenceandmetastasisinsmallhe

6、patocellularcarcinoma.Results:Byunivariateanalysis,betweentheearlyrecurrenceofsmallhepatocellularcarcinomagroupandthelaterecurrencegroup,therestoftheclinicalcasesfactorswerenostatisticalsignificancejnadditiontothepatienfstumorcapsule(P=0・027),thepostoperativepeakvalueoftotalbilirubin(TBIL)(P=0.034)

7、?microvascularinvasionbythemicroscopeexamination(P=0.036)weresignificantlydifferent;Themultivariateanalysissuggestthatthetumorcapsuleisanindependentriskfactorofearlyrecurrenceandmetastasisofsmallhepatocellu