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目的探讨影响人肝细胞癌术后复发和预后的临床病理危险因素．方法应用单因素或多因素显著性检验及Ｗｉｌｃｏｘｏｎｃｏｘ回归检验，对１５６例治疗性切除人肝细胞癌病例进行回顾性临床病理学（包括性别、瘤数、瘤大小、肝包膜浸润及门静脉累及等）分析．结果肝细胞癌１５６例中，首发癌７３例，复发癌８３例，术后复发率５３２％，其中亚临床可再切除复发肝癌６５例，再切除率为７８３％（６５／８３）．全组病例１、２、３、４、５年术后生存率分别为６８４％，５７３％，４６７％，３１５％和２８６％．肝癌术后复发相关的临床病理因素主要是：男性，多个，瘤体大（直径＞５ｃｍ），包膜浸润和门静脉累及等，术后复发率高，无瘤活存时间短（Ｐ＜００５）．结论肝细胞癌术后复发的危险因素为男性，多个（＞２个），体积大（直径＞５ｃｍ），包膜癌浸润和肝门血管癌栓形成等．肝细胞癌术后复发主要为单中心性，肝右前叶为术后复发多发肝段．
Objective To explore the clinicopathological risk factors affecting postoperative recurrence and prognosis of human hepatocellular carcinoma. Methods Retrospective clinical pathology (including gender, number of tumors, tumor size, liver capsular infiltration, portal vein involvement, etc.) was performed on 156 cases of hepatocellular carcinoma undergoing curative resection using univariate or multivariate significance test and Wilcoxoncox regression test. )analysis. Results In 156 cases of hepatocellular carcinoma, there were 73 cases of primary carcinoma and 83 cases of recurrent carcinoma. The recurrence rate was 53. 2%, of which 65 cases were subclinical re-reblesed liver cancer, and the re-resection rate was 78. 3% (65/83). ). The postoperative survival rates of the whole group were 68.4%, 57.4%, 46.7%, 31.5%, and 28.6%, respectively, at 1, 2, 3, 4, and 5 years. The clinical and pathological factors related to recurrence of hepatocellular carcinoma were mainly male, multiple, large tumor size (>5cm in diameter), capsule infiltration, portal vein involvement, etc. The postoperative recurrence rate was high, and the tumor-free survival time was short (P<0. 05). Conclusion The risk factors for postoperative recurrence of hepatocellular carcinoma are male, multiple (>2), large volume (>5cm in diameter), infiltration of capsule carcinoma and portal vein thrombosis. The recurrence of hepatocellular carcinoma was mainly monocentric, and the right hepatic lobe had multiple segments of liver recurrence.