肝胆胰外科杂志2018，Vol.30Issue(3)：182-186,5.DOI:10.11952/j.issn.1007-1954.2018.03.002
微血管侵犯在复发性肝细胞癌中的临床价值
Clinical values of microvascular invasion for recurrent hepatocellular carcinoma patients after radical hepatic resections
摘要
Abstract
Objective To investigate the clinical values of microvascular invasion (MVI) for recurrent hepatocellular carcinoma (HCC) patients after radical hepatic resections. Methods The clinicopathological data of 661 patients with HCC who underwent R0 resection and recurred within 5 years for the first time at Zhongshan Hospital between Jan. 2007 and Dec. 2008 were collected. Correlations of MVI with clinical demographics were evaluated. The influence of MVI on survival and recurrence was also evaluated. Results The incidence of MVI was 31.6% in the study cohort. MVI was correlated with preoperative AFP level (P=0.013), tumor differentiation (P<0.001), tumor capsule (P<0.001), tumor size (P<0.001) and BCLC stage (P=0.025) in the first hepatic resection. MVI was significantly related with the resection rate of recurrent tumor (P=0.003). The 1-, 3-, 5-year overall survival (OS) between MVI positive and negative group were 68.7%, 28.9%, 13.7% and 77.0%, 43.7%, 20.3% respectively, and the median survival time was 22.3 months and 32.5 months (P<0.001). The 1-, 3-, 5-year recurrence free survival (RFS) between MVI positive and negative group were 38.8%, 7.2%, 0 and 49.3%, 16.4%, 0 respectively, the median recurrence free survival time was 8 months and 11.6 months (P<0.001). Among patients who did not receive re-resections, the 1-, 3-, 5-year OS between MVI positive and negative group were 63.7%, 22.2%, 8.9% and 70.4%, 33.1%, 18.2% respectively, and the median survival time was 20.0 months and 25.3 months (P<0.001). However, among patients who received re-resections, the 1-, 3-, 5-year OS between MVI positive and negative group were 96.8%, 66.7%, 41.5% and 96.4%, 74.9%, 56% respectively, and the median survival time was 42.6 months and 48.6 months, which indicated no significance (P=0.248). Conclusion Compare with recurrent HCC patients MVI negative, MVI positive patients show shorter RFS time, poorer OS, and fewer chances of undergoing re-resection. However, similar OS can be obtained if undergoing re-resection, surgery is still the most effective treatment for recurrence in those MVI positive recurrent patients.关键词
癌,肝细胞/术后复发/微血管侵犯/预后Key words
hepatocellular carcinoma/recurrence/microvascular invasion/prognosis分类
医药卫生引用本文复制引用
丁光宇,朱小东,施国明,沈英皓,蔡加彬,孙惠川,周俭,樊嘉,黄成..微血管侵犯在复发性肝细胞癌中的临床价值[J].肝胆胰外科杂志,2018,30(3):182-186,5.基金项目
国家自然科学基金项目(81502006 （）
81572298). （）
