《Clinical and pathological features and surgical treatment of Budd-Chiari syndrome-associated hepatocellular carcinoma.》.pdf

3632 ChinM edJ2013,126fl9) Originalarticle Clinicalandpathologicalfeaturesandsurgical Budd--Chiarisyndrome-associatedhepatocellul WANGYa—dong，XUEHuan-zhou，ZHANGXiao，XUZong—quan，JIANGQing—feng，SHENQuan，YUMiao， LIKeandJIA Meng Keywords：Budd-Chiarisyndrome,hepatocellularcarcinoma,surgicaltreatment,prognosis Background Budd-Chiarisyndrome(BCS)ischaracterizedbyliversinusoidalcongestion，ischemiclivercelldamage， andIiverportalhypertensioncaused byhepaticvenousoutflow constriction．Theaim ofthisresearchwastoinvestigate thecIin；c0path0lOgicalfeaturesofBCS-associatedhepatocellularcarcinoma(HCC)andexploreitssurgicaltreatmentand prognosis． Methods Clinicaldatafr0m 38patientswithBCS．associatedHCCwhoweresurgicallytreatedinourhospitalfr0m July 1998toAugust2010wereretrospectivelyanalyzed．TheclinicOpafhOlOgicalfeaturesandprognosisofpatientswithBCS— associatedHCC andsurgicaItreatmentforBCS．associatedHCCwereinvestiqated． Results ComparedtothepatientswithhepatitisBvirus(HBV)一associatedHCC，thepatientswithBCS—associatedHCC showedafemalepredominance，andhad significantlyhighercirrhosisrate，higherincidenceofsolitarytumors．1ower incidenceofinfiltrativegrowth，higherproportionofmarginalorexogenousgrowth，lowerrateofportalveininvasion， andhigherdegreeofdifferentiation．Mediansurviva1waslongerinpatientswithBCS．associatedHCCf76months)than inthosewithHBVassociatedHCC(38months)．Of38patientswithBCSassociatedHCC。22patientswhoreceived combinedsurgerymainlyby liverresectionpluscavoatriaIshuntsexhibitedhepaticvenousoutflow constrictionrelief． whiletheother16patientsonlyunderwentJiverresection．The combined surgerygroup hadsignificantlyIongersurvivaJ andIowerincidencesofpost-operativeIethaIcomplicationsfP0．O5)．Multivariateanalysisshowedthatreliefofhepatic venousouftlow obstructionwasaprotectivefactorforsurviva