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目的观察肝细胞肝癌(HCC)患者术后准确的复发时间,进一步探讨影响肝癌术后复发的危险因素。方法将我院肝脏外科收治的肝癌肝切除术患者94例根据数字减影血管成像技术(DSA)确诊的术后复发时间分为1~6月复发组、7~12月复发组和1年内无复发组;肝内复发病例予栓塞治疗,并应用栓塞后CT、造影超声、磁共振成像等检查手段予以验证。结果半年复发率为30.9%,1年复发率为36.2%,半年和1年复发率比较差异无显著性。复发组有多发性肿瘤病例9例(26.5%),无复发组5例(8.3%),两组比较差异具有显著性(P=0.032)。通过其他检查手段验证DSA的诊断准确性为87.2%。结论HCC术后复发的高峰时间在术后半年内,肿瘤多发性是导致进展期肝癌术后早期复发的重要因素。DSA是早期发现HCC术后肝内复发的重要手段,同时还可以给予早期治疗、控制复发肿瘤进展并为以后的积极治疗创造条件。
Objective To observe the accurate postoperative recurrence time of patients with hepatocellular carcinoma (HCC) and to further explore the risk factors that influence the recurrence of liver cancer. Methods Ninety-four patients with hepatocellular carcinoma underwent liver surgery in our hospital were divided into 1-June recurrence group, 7-December recurrence group and 1-year non-recurrence group according to digital subtraction angiography (DSA) Recurrence group; intrahepatic recurrent cases to embolization treatment, and the application of embolization CT, contrast-enhanced ultrasound, magnetic resonance imaging and other means to be verified. Results The half-year recurrence rate was 30.9% and the one-year recurrence rate was 36.2%. There was no significant difference in half-year and one-year recurrence rates. There were 9 cases of multiple tumor (26.5%) in recurrence group and 5 cases (8.3%) in non-recurrence group, the difference was significant (P = 0.032). The diagnostic accuracy of DSA was 87.2% verified by other tests. Conclusions The peak recurrence time of HCC is within six months after operation. The multiple tumor is the important factor leading to the early postoperative recurrence of advanced liver cancer. DSA is an early detection of intrahepatic HCC recurrence after an important means, but also can give early treatment, control of recurrent tumor progression and create conditions for the subsequent active treatment.