小肝癌术后早期复发的多因素分析.docVIP

小肝癌术后早期复发的多因素分析 　　作者：潘金强　丁伟 作者单位：新疆医科大学附属中医医院普外科,附属肿瘤医院肝胆胰外科，新疆 乌鲁木齐 830000 　　【摘要】 目的：探讨影响小肝癌术后早期复发的影响因素。方法：回顾性分析2001年1月～2005年12月肿瘤医院收治经病理证实的原发性小肝癌，经手术切除单个结节最大直径≤5 cm 或两个结节最大直径之和≤5 cm 的小肝癌46例。分析肿瘤大小、手术切缘、术中输血及肿瘤数目等与小肝癌术后无瘤生存期的关系。结果：46例病例中早期肝内复发34例。多因素分析表明肿瘤大小、术中输血是早期复发的独立危险因素。结论：肿瘤大小、手术切缘、术中输血是影响病人术后早期肝内复发的重要因素。积极防治复发将是延长术后无瘤生存期的重点。 　　【关键词】 小肝癌; 早期复发; 多因素分析 　　Multivariate analysis on factors of early postoperative intrahepatic recurrence for small liver cancer 　　PAN Jin-qiang, DING Wei 　　(Department of General Surgery, Affiliated Traditional Chinese Medical Hospital, Xinjiang Medical University, Urumqi 830000, China ) 　　Abstract: Objective: To investigate the factors influencing early intrahepatic recurrence after section of small liver cancer. Methods: From January 2001 to December 2005, 46 patients who underwent hepatectomy for small liver cancer (the maximum diameter 5cm in single nudule or the sum of diameters in double nodule equal to or less than 5 cm) were enrolled for reviewing analysis. SPSS 13.0 for window software was used for statistics. The relation were retrospectively reviewed between tumor size, cutting margins, blood transfusion and tumor-free survival of small liver cancer. Results: Early intrahepatic recurrence occurred in 41 of 46 cases. Multivariate analysis showed that tumor size, cutting margins, blood transfusion were independent risk factors. Conclusion: Tumor size, blood transfusion are corelated significantly with early intrahepatic recurrence. Close surveillance and following-up are the keys for prolonging the tumor-free survival time. 　　Key words: small liver cancer; early intrahepatic recurrence; multivariate analysis 　　近十年来原发性肝癌切除术预后已经取得较大程度提高，但远期疗效仍不满意，术后复发是影响疗效的主要原因。本研究将术后2年内肝内复发的病例归为早期复发。本研究以手术切除后无瘤生存率为评价标准，探讨影响小肝癌手术患者预后因素。 　　1 资料与方法 　　1.1 临床资料 2001年1月～2005年12月新疆医科大学附属肿瘤医院共收治小肝癌56例，其中48例行手术切除，2例术后1个月内因肝功能衰竭死亡。小肝癌诊断标准：单个结节最大直径≤5 cm 或两个结节最大直径之和≤5 cm。本组46例，男性37 例，女性9例;年龄37～79岁，平均年龄58.75岁。46例行乙型肝