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老年可切除肝癌伴门静脉癌栓预后的影响因素分析 预览

Prognostic factors of resectable hepatocellular carcinoma with portal vein tumor thrombus in elderly patients
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摘要 目的:探讨老年可切除肝癌伴门静脉癌栓预后的影响因素。方法:选择我院于2014年1月至2017年6月期间收治的老年可切除肝癌伴门静脉癌栓患者127例作为研究对象,均行肝癌根治性切除+门静脉切开取栓、门静脉癌切除、右半肝或者左半肝切除。所有患者出院后开始随访,以每6个月电话或者门诊随访其生存情况,至其死亡或随访至2018年8月。调查资料包括性别、分化程度、肿瘤直径、癌栓分型、合并肝硬化、甲胎蛋白、术后TACE、肝内转移、癌栓类型。结果:随访末,生存患者42例,死亡患者85例。两组患者在性别、分化程度、癌栓类型和甲胎蛋白方面比较无统计学差异(P>0.05);死亡组低分化多于生存组,肿瘤直径≥8cm多于生存组,合并肝硬化多于生存组,术后TACE多于生存组,有肝内转移多于生存组,浸润癌栓类型多于生存组,且有统计学差异(P<0.05)。将上述单因素分析具有统计学差异的纳入多因素分析表明,低分化、肿瘤直径≥8cm、术后TACE、肝内转移和浸润型癌栓为影响肝癌伴门静脉癌栓预后独立危险因素。结论:老年可切除肝癌伴门静脉癌栓预后受多种因素影响,其中分化程度、肿瘤直径、术后TACE、肝内转移和癌栓类型为影响其预后独立危险因素。 Objective:To investigate the prognostic factors of elderly resectable hepatocellular carcinoma( HCC) with portal vein tumor thrombus. Methods: From January 2014 to June 2017,127 elderly patients with resectable hepatocellular carcinoma and portal vein tumor thrombus were selected as subjects. All patients underwent radical hepatectomy plus portal vein thrombectomy,portal vein cancer resection, right or left hepatectomy. All patients were followed up every six months by telephone or out-patient for survival until their deaths or until Au-gust 2018. The data included sex,differentiation,tumor diameter,tumor thrombus type,cirrhosis,AFP,postoperative TACE,intrahepatic me-tastasis,and tumor thrombus type. Results:At the end of the follow-up,42 patients survived and 85 died. There was no significant difference in sex,differentiation,tumor thrombus type and alpha fetoprotein between the two groups(P > 0. 05);low differentiation was more common in the death group than in the survival group,tumor diameter was more than 8 cm in the survival group,cirrhosis was more common in the survival group,postoperative TACE was more common in the survival group,intrahepatic metastasis was more common in the survival group,and infil-trating tumor thrombus was more common in the survival group(P < 0. 05). Multivariate analysis showed that low differentiation,tumor diame-ter≥8 cm,postoperative TACE,intrahepatic metastasis and invasive tumor thrombus were independent risk factors for prognosis of HCC with portal vein tumor thrombus. Conclusion:The prognosis of resectable hepatocellular carcinoma with portal vein tumor thrombus in elderly pa-tients is influenced by many factors,among which differentiation,direct tumor,postoperative TACE,intrahepatic metastasis and type of tumor thrombus are independent risk factors.
作者 陈中建 闻愚 CHEN Zhong-jian;WEN Yu(Department of general surgery, First Affiliated Hospital of Nanyang Medical College ( Nanyang, Henan 473058)China)
出处 《中西医结合肝病杂志》 CAS 2019年第2期137-139,共3页 Chinese Journal of Integrated Traditonal and Western Medicine on Liver Diseases
基金 河南省自然基金项目(No.142102310129).
关键词 肝癌 门静脉癌栓 预后 影响因素 hepatocellular carcinoma portal vein tumor thrombus prognosis influencing factors
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