肝癌根治性切除术后早期复发的危险因素分析

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1、目录缩略词中英文对照表···································1中文摘要···············································2英文摘要···············································4引言·················································6正文·················································71.材料和方法···································

2、·······72.结果···············································93.讨论·············································144.存在问题···········································315.结论·············································32参考文献··············································33附录······························

3、··················38综述················································40致谢················································51攻读学位期间发表的学术论文目录···················52作者声明··············································53个人简历··············································54缩略词中英文对照表AbbreviationALTalaninetr

4、ansaminase丙氨酸氨基转移酶ASTaspartatetransaminase天门冬酸氨基转移酶AFPalphafetoprotein甲胎蛋白AFUalpha-L-fucosidaseα-L-岩藻糖苷酶CA19-9carbohydrateantigen19-9糖类抗原19-9CTcomputedtomographyX线计算机断层扫描DCPdes-gamma-carboxy-prothrombin脱-γ-羧基凝血酶原GGTgammaglutamyltranspeptidaseγ-谷氨酰转肽酶HBVhepaticBvirus乙型肝炎病毒HBsAghepatitisBsurfaceant

5、igen乙型肝炎表面抗体HCVhepaticCvirus丙型肝炎病毒ORoddsratio优势比PLCprimarylivercancer原发性肝癌SPSSStatisticalpackageforsocialscience社会科学统计软件包1中文摘要目的：探讨影响肝癌根治性切除术后早期复发的危险因素，明确影响肝癌根治性切除术后早期复发的独立危险因素。方法：回顾性分析2006年7月1日至2008年10月31日期间收治的102例行肝癌根治性切除术并病理证实的原发性肝癌病历资料，根据术后复发时间将全部资料分为早期复发组（术后1年内有肿瘤复发）和非早期复发组（1年后复发或随访期间无复发），比较

6、可能对术后早期复发有影响的宿主、肿瘤及手术相关因素，包括性别、年龄、症状、乙肝表面抗原、肝硬化情况、术前肝功能Child-Pugh分级、术前血清AFP水平值、术前血清AST水平、肿瘤大小、肿瘤包膜、门静脉癌栓、肿瘤分化程度、微血管浸润、切缘距离、肝门阻断时间、手术中输血情况、手术持续时间、手术中总失血量等18项。结果：1.全组1年内41例复发，复发率40.2%，早期复发组1年生存率为52.2%，2年生存率为13.4%。非早期复发组1年生存率和2年生存率分别为98.6%和90.5%。两组间生存率比较，差异有统计学意义（P<0.01）。2.单因素分析结果显示，早期复发组与非早期复发组比较，肝

7、硬化、肿瘤大小、肿瘤存在包膜、有门静脉癌栓、肿瘤有微血管浸润和术中总失血量6项因素存在差异，有统计学意义（P<0.05）；性别、年龄、症状、乙肝表面抗原、术前肝功能Child-Pugh分级、术前血清AFP水平、术前AST水平、肿瘤分化程度、切缘距离、肝门阻断时间、手术中输血情况、手术持续时间12项因素差异无统计学意义（P>0.05）。3.多因素分析表明，肿瘤大小、门静脉癌栓、肿瘤微血管浸润是影响肝癌早期复发的有统计学意义的因素（P<