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目的探讨肝移植治疗肝细胞型肝癌的临床价值及影响预后的因素。方法对67例接受肝移植治疗、且随访时间≥6个月的肝细胞型肝癌患者的临床资料进行回顾性分析。结果67例患者肝移植术后1年、2年存活率分别为89.96%、65.59%,1年、2年无瘤存活率分别为77.51%、62.49%;单因素分析显示,甲胎蛋白水平、肿瘤最大直径、门静脉癌栓、肿瘤累及肝脏左右两叶、肿瘤分化程度和肿瘤TNM分期是影响无瘤存活率的重要因素,Cox风险模型多因素分析显示,肿瘤最大直径和门静脉癌栓是影响无瘤存活率的独立危险因素。结论肝移植是目前治疗肝细胞型肝癌的有效方法,肿瘤直径>5cm和门静脉癌栓严重影响患者的无瘤存活率。
Objective To investigate the clinical value of liver transplantation for hepatocellular carcinoma and its prognostic factors. Methods The clinical data of 67 patients with hepatocellular carcinoma who underwent liver transplantation and were followed up for 6 months or more were retrospectively analyzed. Results The 67-year and 2-year survival rates of 67 patients were 89.96% and 65.59% after 1 year liver transplantation respectively. The 1-year and 2-year tumor-free survival rates were 77.51% and 62.49% respectively. Univariate analysis showed that the levels of alpha-fetoprotein, The maximum diameter of tumor, portal vein tumor thrombus, tumor involving the left and right lobes of the liver, tumor differentiation and tumor TNM stage are the important factors affecting the tumor-free survival rate. Cox risk model multivariate analysis showed that the maximum tumor diameter and portal vein tumor thrombus were the impact of no Independent risk factors for tumor survival. Conclusion Liver transplantation is an effective method for the treatment of hepatocellular carcinoma. Tumor diameter> 5cm and portal vein tumor thrombus seriously affect the tumor-free survival rate.