论文部分内容阅读
目的 明确影响肝癌肝移植术后长期生存率的危险因素 ,探讨符合中国特点的肝癌肝移植适应证。方法 对 1993～ 2 0 0 3年 59例接受单纯肝移植治疗的原发性肝癌病人的移植术前基本资料和肝癌大小、数目、分布以及血管侵犯等属性采用单因素方法进行回顾性分析。结果 对肝癌肝移植术后长期生存有统计学意义的因素包括 :肝功能Child -Pugh分级、AFP水平、肿瘤大小、肿瘤数、门静脉分支侵犯等 (P <0 0 5)以及上腹部手术史 (P <0 0 1)。对肝癌肝移植术后无瘤生存有影响的因素包括上腹部手术史、肿瘤数 (P <0 0 5) ,肿瘤大小和门脉分支侵犯等 (P <0 0 1)。结论 肝功能Child -PughC分级、上腹部手术史和肿瘤侵犯门静脉分支是降低肝癌肝移植术后长期生存率的危险因素 ;而上腹部手术史、肿瘤 >5cm ,数量 >3个和门脉分支侵犯是缩短肝移植术后无瘤生存时间的危险因素。合并肝硬化 ,肿瘤直径≤ 5cm ,数目≤ 3个 ,无侵犯门静脉分支是肝癌肝移植的最佳适应证 ;门静脉分支侵犯应视为肝移植的禁忌证
Objective To clarify the risk factors of long-term survival after liver transplantation for hepatocellular carcinoma (HCC) and to explore indications of liver transplantation in line with Chinese characteristics. Methods A total of 59 patients with primary liver cancer who underwent simple liver transplantation from 1993 to 2003 were retrospectively analyzed the basic data and the size, number, distribution of hepatocellular carcinoma, and the extent of vascular invasion before transplantation. Results The long-term survival of patients with liver cancer after liver transplantation were statistically significant factors include: liver function Child-Pugh classification, AFP levels, tumor size, number of tumors, portal vein invasion violations (P <0 05) and the history of upper abdominal surgery P <0 0 1). Factors influencing tumor-free survival after liver transplantation include the history of upper abdominal surgery, the number of tumors (P <0.05), the size of the tumor and the invasion of portal branches (P <0.01). Conclusions Child-Pugh classification of liver function, history of upper abdominal surgery and invasion of portal vein are the risk factors for reducing the long-term survival after liver transplantation for liver cancer. However, history of upper abdominal surgery, tumor> 5cm, number> 3 and portal vein branch violation Is to reduce the risk-free survival time after liver transplantation. Liver cirrhosis, tumor diameter ≤ 5cm, the number of ≤ 3, non-invasive portal vein graft liver transplantation is the best indication; portal vein invasion should be considered as a contraindication for liver transplantation