【摘要】：目的:本文通過(guò)回顧性研究343例肝細(xì)胞癌行肝切除術(shù)患者的生存率,探討影響肝細(xì)胞癌手術(shù)治療預(yù)后的相關(guān)因素。方法:回顧性分析自2011年1月至2014年12月期間在河北醫(yī)科大學(xué)第四醫(yī)院肝膽外科行肝切除術(shù)治療的肝細(xì)胞癌患者343例,選取可能對(duì)肝細(xì)胞癌手術(shù)預(yù)后有影響的因素,包括患者的性別、年齡、乙肝表面抗原(HBsAg)、丙肝抗體、肝硬化、術(shù)前AFP水平、術(shù)前ALT水平、Child-Pugh分級(jí)、腫瘤大小、腫瘤數(shù)目、病理脈管癌栓、術(shù)中有無(wú)輸血、TNM分期、BCLC分期等14個(gè)分析因素,通過(guò)電話隨訪、門診復(fù)查等方式,獲得患者是否死亡、死亡時(shí)間等信息。所有數(shù)據(jù)均采用SPSS 17.0軟件進(jìn)行統(tǒng)計(jì)學(xué)分析。計(jì)數(shù)資料采用χ~2檢驗(yàn),計(jì)量資料采用t檢驗(yàn),采用Kaplan-Meier生存分析法比較生存率,單因素分析懫用Log-rank檢驗(yàn),多因素分析采用Cox回歸分析,P0.05為差異有統(tǒng)計(jì)學(xué)意義。結(jié)果:所有343例患者中,存活病例226例(65.9%),死亡病例117例(34.1%),術(shù)后1、3、5年的總體生存率分別為86.3%、64.1%、54.8%。單因素分析結(jié)果顯示術(shù)前AFP水平(P=0.000)、腫瘤大小(P=0.000)、病理脈管癌栓(P=0.000)、TNM分期(P=0.000)及BCLC分期(P=0.000)是肝細(xì)胞癌患者手術(shù)治療預(yù)后的重要影響因素。Cox模型多因素分析結(jié)果示術(shù)前AFP水平(P=0.003)、腫瘤大小(P=0.012)、BCLC分期(P=0.011)為影響本組肝細(xì)胞患者手術(shù)治療預(yù)后的獨(dú)立危險(xiǎn)因素。結(jié)論:AFP水平、腫瘤大小、病理脈管癌栓、TNM分期及BCLC分期是影響肝細(xì)胞癌手術(shù)治療預(yù)后的重要因素。AFP水平、腫瘤大小、BCLC分期是影響肝細(xì)胞癌手術(shù)治療預(yù)后的獨(dú)立危險(xiǎn)因素。
[Abstract]:Objective: to study the survival rate of 343 patients with hepatocellular carcinoma (HCC) undergoing hepatectomy. Methods: 343 patients with hepatocellular carcinoma treated by hepatectomy in the fourth Hospital of Hebei Medical University from January 2011 to December 2014 were analyzed retrospectively. The factors that might influence the prognosis of HCC were selected. Including sex, age, hepatitis B surface antigen (HBsAg), hepatitis C antibody, liver cirrhosis, preoperative AFP level, preoperative ALT level, Child-Pugh grade, tumor size, tumor number, pathological vascular cancer thrombus, intraoperative blood transfusion, TNM staging. There were 14 analysis factors such as BCLC stage and so on. The information of death and time of death were obtained by telephone follow-up and outpatient reexamination. All the data were analyzed by SPSS 17.0 software. The count data were analyzed by 蠂 ~ 2 test, the measurement data by t test, the survival rate by Kaplan-Meier survival method, the single factor analysis by Log-rank test, the multivariate analysis by Cox regression analysis, the difference was statistically significant (P0.05). Results: of 343 patients, 226 (65.9%) survived and 117 (34.1%) died. The overall survival rate was 86.3% and 54.8% respectively. Univariate analysis showed preoperative AFP level (P0. 000), tumor size (P0. 000), pathological vessel tumor thrombus (P0. 000). TNM stage (P0. 000) and BCLC stage (P0. 000) were important factors in prognosis of patients with hepatocellular carcinoma. Multivariate analysis of Cox model showed that preoperative AFP level (P0. 003) and tumor size (P0. 012). BCLC staging (P0. 011) was an independent risk factor for the prognosis of patients with hepatocellular carcinoma. Conclusion: AFP level, tumor size, pathological vascular tumor embolus, TNM staging and BCLC staging are important factors affecting the prognosis of HCC. BCLC staging is an independent risk factor for the prognosis of hepatocellular carcinoma.
【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R735.7

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