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目的探讨影响肝癌切除长期生存率的相关临床因素。方法回顾性分析我院１９８２～１９９２年经手术切除后生存５年以上肝癌患者３１例，同时将同期生存５年以下的５６例肝癌术后患者进行对照研究。结果两组病例在中位年龄、性别、术前ＡＦＰ阴性、术后ＴＡＣＥ治疗、术后复发再切术方面统计学差异无显著性（Ｐ＞０．０５）；无症状而体检发现肝癌、根治性切除、肿瘤数目、肿瘤包膜、切缘距离、门静脉分支癌栓、肝硬化及肿瘤大小方面，两组病例统计学差异有显著性（Ｐ＜０．０５）。另外，分析组病例中小肝癌比例明显高于对照组（１９／３１比１３／５６），Ｐ＜０．００５。结论肝癌的早期发现及根治性切除是提高其５年生存率的重要手段；乙肝后肝硬化的肝癌患者预后较差；切缘距离是否作为独立预后因素尚有待进一步研究。
Objective To explore the relevant clinical factors affecting the long-term survival rate of liver cancer resection. Methods A retrospective analysis of 31 patients with hepatocellular carcinoma who survived for more than 5 years after surgical resection in our hospital from 1982 to 1992, and a comparative study of 56 patients with liver cancer who survived for less than 5 years in the same period. Results There was no statistically significant difference in median age, gender, preoperative AFP negative, postoperative TACE, postoperative recurrence and recurrence in the two groups (P>0.05); asymptomatic and liver cancer found on physical examination The degree of resection, tumor number, tumor capsule, margin distance, portal vein branch cancer thrombus, liver cirrhosis and tumor size were statistically significant between the two groups (P<0.05). In addition, the proportion of small hepatocellular carcinoma in the analysis group was significantly higher than that in the control group (19/31 vs. 13/56), P<0.005. Conclusion Early detection and radical resection of liver cancer are important means to improve the 5-year survival rate; The prognosis of liver cancer patients with hepatic cirrhosis after hepatitis B is poor; whether the margin distance as an independent prognostic factor remains to be further studied.