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目的:探讨影响原发性肝细胞性肝癌(hepatocellular carcinoma,HCC)术后复发的因素,为术中术后治疗及判断预后提供依证据。方法:回顾分析1998年1月～2005年6月,我院94例HCC术后复发病例的临床和病理资料,将病人分为近期复发(≤2年)和远期复发(>2年)两组,分析比较两组患者的性别、年龄、初诊症状、HBsAg、肝功能Child分级、AFP值、肝硬化、肿瘤病灶、肿瘤大小、肿瘤包膜、血管侵犯和转移、手术切缘、病理分级、术后综合治疗、再次手术和术中出血量等在近远期复发有无差异。结果:肝癌术后2年内和2年后复发在肿瘤大小、肿瘤包膜、血管侵犯和转移、手术切缘、术中出血量、术后综合治疗以及再次手术的差异有统计学意义,是复发的危险因素;而在性别、年龄、初诊症状、HBsAg,肝硬化、肝功能Child分级、AFP值、肿瘤病灶和病理分级上的差异无统计学意义。结论:影响HCC肝切除术后近期和远期复发的临床和病理因素可能不同,早期发现肝癌,规范的手术切除,减少手术出血量,术后复发采取综合治疗是改善患者预后的重要措施。
Objective: To explore the factors influencing the recurrence of primary hepatocellular carcinoma (HCC) and provide evidence for postoperative treatment and prognosis. Methods: The clinical and pathological data of 94 patients with recurrent HCC postoperatively from January 1998 to June 2005 were retrospectively analyzed. The patients were divided into two groups: recent recurrence (≤2 years) and long-term recurrence (> 2 years) The patients were divided into two groups according to sex, age, first visit symptoms, HBsAg, Childhood grading, AFP, cirrhosis, tumor size, tumor size, tumor capsule, vascular invasion and metastasis, surgical margins, pathological grade, Postoperative comprehensive treatment, reoperation and intraoperative blood loss in the near and distant recurrence with or without the difference. Results: The recurrence of hepatocellular carcinoma within 2 years and 2 years after operation was statistically significant in terms of tumor size, tumor capsule, vascular invasion and metastasis, surgical margin, intraoperative blood loss, postoperative comprehensive treatment and reoperation There was no significant difference in gender, age, first visit symptom, HBsAg, cirrhosis, Child classification of liver function, AFP value, tumor focus and pathological grade. Conclusion: The clinical and pathological factors that affect the recurrence of HCC after liver resection may be different. The early detection of HCC, standardized surgical resection, reduction of surgical bleeding, and comprehensive treatment after recurrence are important measures to improve the prognosis of patients.