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目的:探讨门静脉癌栓(PVTT)对原发性肝癌(肝癌)生物学特性的影响。方法:对310例肝癌患者的临床资料进行回顾性分析。根据门静脉是否有癌栓,分为门静脉癌栓组与非门静脉癌栓组,分别统计确诊时两组肿瘤的大小、分布、有无远处转移,肝功能状况、门静脉高压的情况及治疗并作分析。结果:310例肝癌患者中门静脉癌栓组76例(24.5%),非门静脉癌栓组234例(75.5%)。与非门静脉癌栓组比较,门静脉癌栓组的平均年龄小(P<0.05),肿瘤往往侵犯多个肝叶(P<0.01),门静脉高压、上消化道出血的发生率高(均为P<0.005),肝功能损害更明显(P<0.05),肿瘤切除率低(P<0.005),均具有统计学意义。而肿瘤的大小、血清甲胎蛋白水平及远处转移例数两组比较无统计学差异。结论:PVTT与肝癌的大小、远处转移无直接关系;伴有PVTT的肝癌易肝内播散,累及多个肝叶,门静脉高压明显,肝功能代偿能力差。因此,PVTT是影响肝癌预后的一个极为重要的因素。
Objective: To investigate the effect of PVTT on the biological characteristics of primary liver cancer (HCC). Methods: The clinical data of 310 patients with liver cancer were analyzed retrospectively. According to whether the portal vein tumor thrombus, divided into portal vein tumor thrombosis group and non-portal vein tumor thrombosis group were statistically diagnosed with tumor size, distribution, with or without distant metastasis, liver function, portal hypertension and treatment analysis. Results: Among 310 patients with HCC, 76 (24.5%) had portal vein thrombosis and 234 (75.5%) had non-portal vein thrombosis. Compared with the non-portal vein thrombosis group, the mean age of the portal vein tumor embolus group was small (P <0.05). The tumor often infringed on multiple liver lobes (P <0.01), and the incidence of portal hypertension and upper gastrointestinal bleeding was high <0.005), liver function damage was more obvious (P <0.05), tumor resection rate was lower (P <0.005), both of which were statistically significant. The tumor size, serum alpha-fetoprotein levels and distant metastasis cases no significant difference between the two groups. Conclusion: PVTT is not directly related to the size and distant metastasis of hepatocellular carcinoma. The hepatocellular carcinoma with PVTT is easily disseminated in the liver and involves multiple liver lobes. The portal hypertension is obvious and the hepatic decompensation ability is poor. Therefore, PVTT is an extremely important factor affecting the prognosis of liver cancer.