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目的探讨肝细胞癌(HCC)术后早期复发的危险因素。方法收集东方肝胆外科医院1996至2006年收治的临床病理学数据及随访结果完整的复发性肝癌178例。选取20项临床病理学参数,以2年为早期复发的时限,应用COX风险比例模型进行单因素与多因素分析,筛选早期复发的独立危险因素。结果经过COX风险比例模型分析,发现谷草转氨酶升高(HR=1.447,95%CI=1.013~2.067,P=0.042)、肝硬化(HR=2.327,95%CI=1.564~3.462,P<0.001)、肿瘤分布超过半肝(HR=2.690,95%CI=1.288~5.616,P=0.008)和伴有血管侵犯(HR=1.820,95%CI=1.219~2.716,P=0.003)是HCC术后早期复发的独立危险因素。结论 HCC术后早期复发受多种因素影响,对于伴有早期复发危险因素的HCC患者,应加强术后随访,以期及早发现复发并积极治疗,改善患者预后。
Objective To investigate the risk factors of early recurrence of hepatocellular carcinoma (HCC) after operation. Methods The clinical pathology data of Eastern Hepatobiliary Surgery Hospital from 1996 to 2006 were collected and 178 cases of complete recurrent hepatocellular carcinoma were followed up. Twenty clinical and pathological parameters were selected. Two-year follow-up was used to predict the risk of early relapse by single factor and multiple factor analysis using COX risk proportional model. Results After COX proportional hazard model analysis, aspartate aminotransferase (HR = 1.447, 95% CI = 1.013-2.067, P = 0.042) and cirrhosis (HR = 2.327, 95% CI = 1.564-3.462, P <0.001) (HR = 2.690, 95% CI = 1.288-5.616, P = 0.008) and vascular invasion (HR = 1.820, 95% CI = 1.219-2.716, P = 0.003) Recurrence of independent risk factors. Conclusion The early postoperative recurrence of HCC is affected by many factors. Patients with HCC with early risk factors for recurrence should be followed up in order to detect early relapse and aggressive treatment, and to improve prognosis.