布加综合征合并肝细胞癌的临床特点及预后
吴康;许伟;祖茂衡;徐浩;顾玉明;张庆桥;魏宁;崔艳峰
【期刊名称】《中华肝胆外科杂志》 【年(卷),期】2016(022)003
【摘要】目的 探讨布加综合征(BCS)合并肝细胞癌(HCC)的临床特点及预后.方法 回顾性分析33例BCS合并HCC患者的临床资料.33例患者均行下腔静脉成形术序贯肝癌切除治疗,其中16例术后行预防性肝动脉化疗栓塞(TACE).选择同期于我院行肝癌切除术的乙型肝炎病毒(HBV)合并HCC患者110例作为对照,其中52例术后行预防性TACE.对两组患者的临床病理特征、手术情况、无瘤生存期和总体生存期进行分析对比.结果 BCS合并HCC组患者的性别、年龄分布以及肝功能Child-Pugh分级、甲胎蛋白、肿瘤大小与HBV合并HCC组差异无统计学意义(P＞0.05).BCS合并HCC组肿瘤单发率、边缘及外生型生长率和高分化率高于HBV合并HCC组,而门静脉侵袭率则低于HBV合并HCC组,差异均有统计学意义(P＜0.05).BCS合并HCC组患者有较少的术中出血量[(432.3±125.8) ml比(565.2±143.2) ml,P＜0.05]、较短的手术时间[(132.8±25.5) min比(173.7±32.3) min,P＜0.05]及较短血流阻断时间[(15.3±3.6) min比(21.9±7.4) min,P＜0.05].BCS合并HCC患者1、3、5年总体生存率分别为93.1％、74.1％、55.2％,HBV合并HCC患者为82.6％、45.9％、17.3％;BCS合并HCC患者1、3、5年无瘤生存率分别为86.2％、51.7％、0,HBV合并HCC患者为57.1％、10.2％、0.两组总体生存率、无瘤生存率比较差异显著(P均＜0.05).结论 BCS合并的HCC较HBV合并的HCC恶性程度低,预后好,下腔静脉成形术序贯肝癌切除治疗BCS合并HCC安全、有
效.%Objective To analyze the clinicopathological features and prognosis of Budd-Chiari syndrome (BCS) associated with hepatocellular carcinoma (HCC).Methods The clinical data of 33 patients with HCC complicated by BCS were retrospectively analyzed.All the patients underwent sequential percutaneous transluminal angioplasty to relief the obstruction of the inferior vena cava and then hepatic resection for HCC.There were 16 of these patients (48.5％) who underwent postoperative adjuvant TACE.For comparison,110 patients with HBsAg + HCC were randomly selected,and 52 of these patients (47.3 ％) underwent
postoperative
adjuvant
TACE.The
clinicopathological,operative outcomes,disease-free survival and overall survival rates between these 2 groups of patients were compared.Result There were no significant differences in gender,age,Child Pugh,AFP and tumor size.However,patients with BCS-associated HCC had significantly higher
incidences
of
solitary
tumors,marginal
or
exogenous
growths,poor degrees of tumour differentiation but a lower rate of portal vein invasion.They also had significantly less intraoperative blood loss [(432.3 ± 125.8) ml vs (565.2 ± 143.2) ml,P ＜ 0.05],shorter operation time [(132.8 ± 25.5) min vs (173.7 ± 32.3) min,P ＜ 0.05] and shorter vascular clamping time [(15.3 ± 3.6) min vs (21.9 ± 7.4) min,P ＜ 0.05] when compared with patients with HBV associated HCC.The 1-,3-,5-year overall survival rates were 93.1％,74.1％,55.2％,respectively,for
patients with BCS-associated HCC and
82.6％,45.9％,17.3％,respectively,for patients with HBV-associated HCC.The corresponding 1-,3-,5-year disease-free survival rates were 86.2％,51.7％,0,respectively,versus 57.1％,10.2％,0,respectively.The differences in overall and disease-free survival rates between the two groups were significant (P ＜0.05).Conclusions BCS-associated HCC had more favorable biological behavior and prognosis than HBVassociated HCC.Sequential treatment with percutaneous transluminal angioplasty and hepatic resection could be carried out effectively and safely in these patients.
【总页数】5页(159-163)
【关键词】布加综合征;肝细胞癌;血管成形术;肝切除术;预后 【作者】吴康;许伟;祖茂衡;徐浩;顾玉明;张庆桥;魏宁;崔艳峰
【作者单位】221006 徐州医学院附属医院介入放射科;221006 徐州医学院附属医院介入放射科;221006 徐州医学院附属医院介入放射科;221006 徐州医学院附属医院介入放射科;221006 徐州医学院附属医院介入放射科;221006 徐州医学院附属医院介入放射科;221006 徐州医学院附属医院介入放射科;221006 徐州医学院附属医院介入放射科 【正文语种】中文 【中图分类】 【文献来源】
https://www.zhangqiaokeyan.com/academic-journal-cn_chinese-
布加综合征合并肝细胞癌的临床特点及预后
