原发性肝癌切除术后预后因素的Cox模型分析的论文.docVIP

　　原发性肝癌切除术后预后因素的Cox模型分析的论文 【关键词】 肝细胞癌 ；肝切除术；cox比例风险模型； 预后 【摘要】 目的探讨影响原发性肝癌切除术后预后因素，为其临床综合治疗及判断预后提供依据。 方法回顾性分析广西医科大学第一附属医院经根治性手术切除的145例原发性肝癌的临床病理资料，对可能影响预后的各种因素进行单因素分析，将单因素分析中可能影响预后的指标依次引入cox比例风险模型进行多因素分析。结果全组1、3、5年复发率分别为39.3％、68.3%和82.8%，总生存率分别为76.6%、39.3%和24.1%。单因素分析显示，年龄、肿瘤包膜形成、肿瘤包膜浸润、门脉癌栓、微血管浸润、肿瘤直径和肿瘤早期复发对预后有影响(plt;0.05)。多因素分析表明肿瘤早期复发、门脉癌栓、微血管浸润为影响肝癌预后的独立因素。结论原发性肝细胞癌的预后是由多种因素决定的，肿瘤早期复发、门脉癌栓、微血管浸润是影响其预后的最主要因素。及早发现、早期规范的治疗是提高肝癌患者预后的关键。 【关键词】 肝细胞癌 ；肝切除术；cox比例风险模型； 预后 cox model analysis of prognostic factors after radical hepatectomy for primary hepatocellular carcinoma huang jinqiu1, peng minhao2, zou quanqing2，yang dinghua2, chen bin2, xiao kaiyin2 1. department of hepatobiliary pancreatic surgery, nanhua hospital attached to university of south china, hengyang 421000,china 2.department of hepatobiliary surgery, the first affiliated hospital,guangxi medical university, nanning 530021,china corresponding auther:peng minhao: email: minhaopeng@yahoo..abstract：objective to evaluate the prognostic factors in hepatocellular carcinoma patients after radical heptoectomy and provide guidance for clinical prehensive therapy.methodsthe clinical data of 145 patients a treated y in the first affiliated hospital of guangxi meical university from june 2000 to december 2002 ine the possible prognostic factors. selected key factors odel, then multivariate analysis or capsule formation,tumor capsule invasion, portal vein cancer thrombus, microvessel invasion, tumor diameter and tumor early recurrence ultivariate analysis indicated that tumor early recurrence, portal vein cancer thrombus and micro vessel invasion ary hepatocellular carcinoma is determined by major factors including tumor early recurrence ,portal vein cacer thrombus and microvessel invasion. early detection and early standard treatment of hcc are important to improve cancer prognosis. key a; hepatectomy; cox proportional hazard model; prognosis 1资料和方法 1．1一般资料收集我院2000年6月～2002年12月接受根治性切除并具有完整临床病理资料的原发性肝细胞