【摘要】：[目的]本研究旨在探求肝細(xì)胞癌切除術(shù)后早期復(fù)發(fā)轉(zhuǎn)移的影響因素,有助于對術(shù)后復(fù)發(fā)危險(xiǎn)因素患者進(jìn)行臨床干預(yù),降低術(shù)后復(fù)發(fā)轉(zhuǎn)移率,延長患者無瘤生存期,改善疾病預(yù)后。[方法]回顧性分析昆明醫(yī)科大學(xué)第二附屬醫(yī)院肝膽胰外科一區(qū)2007年01月01日至2016年1月31日期間行手術(shù)切除并經(jīng)術(shù)后病理證實(shí)為肝細(xì)胞癌共68例患者的病歷資料。根據(jù)患者是否在1年內(nèi)復(fù)發(fā)將其分為1年內(nèi)復(fù)發(fā)組(n=33)和1年內(nèi)未復(fù)發(fā)組(n=35)。將可能影響HCC患者術(shù)后早期復(fù)發(fā)轉(zhuǎn)移的48項(xiàng)因素納入研究,對隨訪結(jié)果及收集的臨床資料采用SPSS 21.0軟件進(jìn)行統(tǒng)計(jì)分析,單因素分析采用:卡方檢驗(yàn)、t檢驗(yàn);對有統(tǒng)計(jì)學(xué)意義的因素再進(jìn)行二元Logistic多因素回歸分析,篩選肝癌術(shù)后早期復(fù)發(fā)轉(zhuǎn)移的獨(dú)立影響因素。[結(jié)果]1.截止到2017年01月31日,共隨訪72例患者,4例失訪,失訪率5.56%。2.單因素分析結(jié)果顯示:腫瘤分化程度、手術(shù)時(shí)間、脈管癌栓、術(shù)前AFP、術(shù)后輔助治療等因素對術(shù)后早期復(fù)發(fā)轉(zhuǎn)移有影響。3.多因素分析顯示:腫瘤分化差、手術(shù)時(shí)間長、術(shù)前AFP (400ng/ml)為影響肝癌術(shù)后早期復(fù)發(fā)的獨(dú)立危險(xiǎn)因素,術(shù)后輔助治療為影響肝細(xì)胞癌術(shù)后早期復(fù)發(fā)轉(zhuǎn)移的保護(hù)性因素。[結(jié)論]腫瘤分化差、手術(shù)時(shí)間長、術(shù)前AFP (400ng/ml)為影響肝細(xì)胞癌術(shù)后早期復(fù)發(fā)轉(zhuǎn)移的獨(dú)立危險(xiǎn)因素,術(shù)后輔助治療為HCC術(shù)后早期復(fù)發(fā)轉(zhuǎn)移的保護(hù)性因素。我們建議術(shù)后對具有上述危險(xiǎn)因素患者應(yīng)加強(qiáng)隨訪,必要時(shí)采取輔助治療措施。
[Abstract]:[objective] to explore the influencing factors of early recurrence and metastasis of hepatocellular carcinoma (HCC) after resection, and to help patients with recurrence and metastasis to carry out clinical intervention, reduce the rate of recurrence and metastasis, and prolong the tumor-free survival of the patients. Improve the prognosis of disease. [methods] the medical records of 68 patients with hepatocellular carcinoma (HCC) confirmed by postoperative pathology from January 01, 2007 to January 31, 2016 in the first region of Department of Hepatobiliary and Pancreatic surgery, second affiliated Hospital of Kunming Medical University, were retrospectively analyzed. According to whether the patient recurred within 1 year, the patients were divided into 1 year recurrence group (nong33) and 1 year non-recurrence group (nf35). 48 factors which may affect the early recurrence and metastasis of HCC patients were included in the study. The follow-up results and clinical data were analyzed by SPSS 21.0 software. The single factor analysis was carried out by chi-square test and t test. The multivariate Logistic regression analysis was used to screen the independent factors of early recurrence and metastasis of liver cancer. [result] 1. By January 31, 2017, a total of 72 patients had been followed up and 4 patients had lost their visits, with a loss rate of 5. 56 and 2. 2. Univariate analysis showed that tumor differentiation, operative time, vascular tumor embolus, preoperative AFP, and postoperative adjuvant therapy had influence on early recurrence and metastasis. Multivariate analysis showed that tumor differentiation was poor, operation time was long, preoperative AFP (400ng/ml) was an independent risk factor for early recurrence of HCC, and postoperative adjuvant therapy was the protective factor affecting early recurrence and metastasis of HCC. [conclusion] AFP (400ng/ml) is an independent risk factor for early recurrence and metastasis of hepatocellular carcinoma (HCC), and adjuvant therapy is the protective factor for early recurrence and metastasis after HCC. We recommend that patients with these risk factors should be followed up and treated with adjuvant treatment if necessary.
【學(xué)位授予單位】：昆明醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R735.7

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