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中国临床研究英文版:2022,35(4):498-502
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原发性肝癌隐匿型破裂对患者术后预后的影响
(1. 菏泽市立医院肝胆外科, 山东 菏泽 274000;2. 菏泽市立医院病理科,山东 菏泽 274000)
Effect of occult rupture of primary hepatocellular carcinoma on postoperative prognosis of patients
摘要
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Received:September 24, 2021   Published Online:April 20, 2022
中文摘要: 方法 回顾性分析2006年1月至2016年9月于菏泽市立医院因原发性HCC接受择期肝切除397例患者的临床资料。 结果 隐匿型破裂HCC患者31例(7.8%,破裂组),无肿瘤破裂者366例(92.2%,非破裂组)。破裂组患者1、3和5年的总体生存率(46.7%、17.8%和15.2%),低于非破裂组(84.5%、53.3%和47.4%),差异有统计学意义(P<0.01);破裂组1、3和5年无瘤生存率(22.9%、 15.2%和5.9%)低于非破裂组(71.4%、 40.0%和35.5%),差异有统计学意义(P<0.01)。随访期间隐匿型破裂HCC患者26例死亡,死因为HCC相关复发者25例,肝病相关死亡1例。Cox回归模型分析示,非R0切除是影响隐匿型破裂HCC患者无瘤生存的独立危险因素[RR=5.464, 95%CI (2.070~14.422),P<0.01]。 结论 隐匿型肿瘤破裂是HCC患者术后预后的重要影响因素,接受非R0切除的隐匿型破裂HCC术后无瘤生存较差。
中文关键词: 肝细胞癌  隐匿  破裂  复发  肝切除  预后
Abstract:Objective To explore the prognosis of patients with the occult rupture of primary hepatocellular carcinoma(HCC) after elective hepatectomy. Methods A retrospective analysis was performed on the clinical data of 397 HCC patients receiving elective hepatectomy in Heze Municipal Hospital from January 2006 to September 2016. Results There were 31 patients(7.8%) with occult rupture of HCC (ruptured group) and 366 patients (92.2%) without occult rupture of HCC(unruptured group).The overall survival rates at 1-, 3-and 5-year were 46.7%, 17.8% and 15.2%,respectively in rupture group and were lower than those(84.5%, 53.3% and 47.4%) in unruptured group(P<0.01). The disease-free survival (DFS) rates at 1-, 3-and 5-year were 22.9%, 15.2%, 5.9%,respectively in ruptured group and were significantly lower than those(71.4%, 40.0%, 35.5%) in unruptured group (P<0.01). A total of 26 cases died in ruptured group, 25 cases died of HCC related recurrence, and 1 case died of liver disease during follow-up period. 〖JP2〗Cox regression analysis showed that the non-complete resection (R0) was an independent risk factor for DFS in patients with occult ruptured HCC[RR=5.464, 95%CI (2.070-14.422),P<0.01]. Conclusion The occult tumor rupture is an important factor for HCC patients' prognosis after undergoing hepatectomy. The patients with occult ruptured HCC receiving non-R0 resection have poor DFS.
文章编号:     中图分类号:R735.7    文献标志码:B
基金项目:2021年菏泽市立医院科技发展计划项目(2021YN78)
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