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目的探讨肝癌肝移植的筛选标准和术后肿瘤复发的影响因素,进一步提高肝癌肝移植疗效方法回顾性分析了第二军医大学附属长征医院2001年12月至2007年12月实施255例肝癌肝移植的临床资料。结果符合Milan标准和超出Milan标准者术后总体存活率和无瘤存活率差异无统计学意义;符合UCSF标准和超出UCSF标准病人术后总体存活率和无瘤存活率差异无统计学意义;符合Milan标准和符合UCSF标准病人术后总体存活率和无瘤存活率差异无统计学意义;TNM分期、门静脉有无癌栓和术前AFP水平等与术后无瘤存活率明显相关;肿瘤病理分级及术前局部治疗等与术后无瘤存活率无明显相关。TNM分期、门静脉癌栓和术前AFP水平是影响肝癌肝移植术后无瘤存活率和总体存活率的独立危险因素。结论肝移植是治疗肝癌的有效手段,UCSF标准因疗效与Milan标准差异无统计学意义,但适应证范围扩大而渐被推广应用;TNM分期、术前AFP水平和门静脉有无癌栓等与术后肿瘤复发或转移密切相关
Objective To investigate screening criteria of liver transplantation for liver cancer and the influencing factors of postoperative tumor recurrence and to further improve the efficacy of liver transplantation for liver cancer.Methods A retrospective analysis of 255 cases of liver cancer liver transplantation from December 2001 to December 2007 in Changzheng Hospital Affiliated to Second Military Medical University was conducted. The clinical data. Results There was no significant difference in postoperative overall survival rate and tumor-free survival rate when meeting the Milan standard and beyond the Milan standard. There was no significant difference between the UCSF standard and the UCSF standard postoperative overall survival rate and tumor-free survival rate; There was no significant difference between the Milan standard and the UCSF standard postoperative overall survival rate and tumor-free survival rate; TNM stage, portal vein tumor thrombosis and preoperative AFP levels were significantly correlated with postoperative tumor-free survival rate; tumor pathological grade And preoperative local treatment and postoperative tumor-free survival rate was not significantly correlated. TNM staging, portal vein tumor thrombus and preoperative AFP levels were independent risk factors for tumor-free survival and overall survival after liver transplantation for liver cancer. Conclusions Liver transplantation is an effective treatment for hepatocellular carcinoma. There is no significant difference between UCSF standard and Milan standard because of the curative effect, but the range of indications is gradually expanded and gradually promoted. TNM staging, preoperative AFP level and portal vein tumor thrombus and other After tumor recurrence or metastasis are closely related