摘要
AIM： To investigate the clinicopathological risk factors for immediate post-operative fatal recurrence of hepatocellular carcinoma （HCC）, which may have practical implication and contribute to establishing high risk patients for pre- or post-operative preventive measures against HCC recurrence. METHODS： From June 1994 to May 2004, 269 patients who received curative resection for HCC were reviewed. Of these patients, those who demonstrated diffuse intrahepatic or multiple systemic recurrent lesions within 6 mo after surgery were investigated （fatal recurrence group）. The remaining patients were designated as the control group, and the two groups were compared for clinicopathologic risk factors. RESULTS： Among the 269 patients reviewed, 30 patients were enrolled in the fatal recurrence group. Among the latter, 20 patients showed diffuse intrahepatic recurrence type and 10 showed multiple systemic recurrence type. Multivariate analysis between the fatal recurrence group and control group showed that preoperative serum alpha-fetoprotein （AFP） level was greater than 1 000 μg/L （P= 0.02; odds ratio = 2.98）, tumor size greater than 6.5 cm （P= 0.03; OR= 2.98）, and presence of microvascular invasion （P= 0.01; OR=4.89） were the risk factors in the fatal recurrence group. The 48.1% of the patients who had all the three risk factors and the 220 of those who had two risk factors experienced fatal recurrence within 6 mo after surgery. CONCLUSION： Three distinct risk factors for immediate post-operative fatal recurrence of HCC after curative resection are pre-operative serum AFP level 〉 1 000 μg/L,tumor size〉6.5 cm, and microvascular invasion. The high risk patients with two or more risk factors should be the candidates for various adjuvant clinical trials.
瞄准：调查 clinicopathological 风险因素因为肝细胞癌(HCC ) 的立即的手术后的致命的复发，它可以有实际牵连并且贡献高建立对 HCC 复发为外科手术前或手术后的预防措施冒病人的风险。方法：从 1994 年 6 月到 2004 年 5 月，为 HCC 收到了药品切除术的 269 个病人被考察。这些病人，在外科以后在 6 瞬间以内表明了弥漫的 intra 肝或多重的全身的周期性的损害的那些被调查(致命的复发组) 。留下的病人被指定为控制组，并且二个组为临床病理风险因素被比较。结果：在考察的 269 个病人之中， 30 个病人在致命的复发组被注册。在后者之中， 20 个病人证明弥漫的 intra 肝的复发类型和 10 显示出的多重全身的复发打字。在致命的复发组和控制组之间的 Multivariate 分析证明那外科手术前的浆液 alpha-fetoprotein (法新社) 水平比 1,000 microg/L 大(P = 0.02；机会比率 = 2.98 ) ，比 6.5 厘米大的肿瘤尺寸(P = 0.03；或 = 2.98 ) ，并且微脉管的侵略的存在(P = 0.01；或 = 4.89 ) 是在致命的复发组的风险因素。有所有三个风险因素的 48.1% 病人和有二个风险因素的 22% 那些在外科以后在 6 瞬间以内经历了致命的复发。结论：为在药品切除术以后的 HCC 的立即的手术后的致命的复发的三个不同风险因素是外科手术前的浆液法新社水平 > 1,000 microg/L，肿瘤尺寸 > 6.5 厘米，和微脉管的侵略。有二的高风险病人或更多的风险因素应该是各种各样的辅助临床的试用的候选人。
