目的探讨混合型肝癌的临床病理学特征以及影响手术治疗的预后因素。方法回顾性分析四川大学华西医院1995~2010年期间行手术切除的31例混合型肝癌患者临床资料,对其预后影响因素进行单因素和多因素分析。结果患者以男性居多(25例,80.6%),中位年龄58岁;乙肝表面抗原阳性者23例(74.2%),AFP≥20μg/L者13例(41.9%),伴肝硬变者18例(58.1%),8例(25.8%)伴淋巴结转移。术后1、3及5年生存率分别为61.3%、32.3%和12.9%,中位生存时间为22个月。单因素分析结果显示门静脉侵犯、镜下癌栓、淋巴结转移和切缘阳性是影响预后的不良因素。多因素分析结果提示淋巴结转移和切缘阳性是影响预后的独立危险因素。结论混合型肝癌预后差。R0切除可能提供给患者获得长期生存的唯一机会。 Objective To investigate the clinicopathological characteristics of mixed hepatocellular carcinoma (HCC) and prognostic factors of surgical treatment. Methods The clinical data of 31 patients with hepatocellular carcinoma (HCC) who underwent surgical resection from 1995 to 2010 in West China Hospital of Sichuan University were retrospectively analyzed. Univariate and multivariate analyzes were performed on the prognostic factors. Results The majority of patients were male (25 cases, 80.6%) with a median age of 58 years. 23 (74.2%) were HBsAg positive, 13 (41.9%) were AFP≥20 μg / L, Cases (58.1%), 8 cases (25.8%) with lymph node metastasis. The 1, 3 and 5-year survival rates were 61.3%, 32.3% and 12.9%, respectively. The median survival time was 22 months. Univariate analysis showed that portal vein invasion, microscopic embolectomy, lymph node metastasis and positive margins were the adverse prognostic factors. Multivariate analysis suggested that lymph node metastasis and positive margins were independent prognostic risk factors. Conclusions Mixed liver cancer has a poor prognosis. R0 resection may provide patients with the only chance of long-term survival.