中文摘要：

目的评估肝癌肝移植受者应用西罗莫司对肿瘤复发和受者存活的影响。方法回顾性分析2006年1月至2011年1月行肝癌肝移植的142例受者的资料，根据术后是否应用西罗莫司分为研究组（62例）和对照组（80例）。采用生存分析方法比较两组患者的无瘤生存时间、带瘤生存时间及受者对西罗莫司的耐受性。结果两组受者无瘤生存率的差异无统计学意义（P〉O．05）。两组符合米兰标准者、超过米兰标准且符合美国加州大学旧金山分校（UCSF）标准者、超过UCSF标准者分别相比较，受者无瘤生存率的差异无统计学意义（P〉0．05）。对照组中有35例肝移植后肿瘤复发，其中21例肿瘤复发后加用西罗莫司，带瘤生存时间中位数为12个月；14例复发后继续使用原有免疫抑制剂，带瘤生存时间中位数为8个月；两者带瘤生存时间的差异有统计学意义（P=0．039）。研究组新发糖尿病发生率低于对照组，但是口腔溃疡和高脂血症发生率却高于对照组，差异均有统计学意义（P〈0．05）。结论未发现西罗莫司能明显降低肝癌肝移植后肿瘤复发率，但移植后肿瘤复发者应用西罗莫司可延长其带瘤生存时间；应用西罗莫司者移植后糖尿病的发生率较低。

英文摘要：

Objective To investigate the influence of sirolimus-based immunosuppressive protocols on the survival and tumor recurrence in liver transplantation （LT） recipients with hepatocellular carcinoma （HCC）. Method We retrospectively analyzed 142 patients who underwent LT for HCC in our hospital during Jan. 2006 to Jan. 2011, who were divided into SRI.-treat group （62 cases） and control group （80 cases） The disease-free and tumor bearing survival time were compared using the Kaplan-Meier method. Results No significant difference was observed between these two groups with the disease-free survival time （DFS）. There were no significant differences of the DFS patients who meet milan criteria, between milan UCSF and beyond UCSF criteria between these two groups. In the control group, the median tumor bearing survival time was 12 months （3-47 months） in 21 patiens who add the SRL in the immunosuppressive protocols after tumor recurrence, which was 8 months （6-22months） in 14 patients who continue the used immunosuppressive protocols after tumor recurrence. There was significant difference in the tumor bearing survival time between these patients （P = 0. 039）. Compared with the control group, the SRL group had significantly lower diabetes while had a higher rate of hyperlipemia and oral ulcer （P〈0. 05）. Conclusion The sirolimusbasd immunosuppression may not benefit for all HCC patients after LT, but it may inhibit the growth of tumor and prolong the survival time of patients with tumor recurrence after LT; it can reduce the diabetes rate.