目的明确肝细胞癌门静脉癌栓(PVTT)形成的临床相关因素。方法回顾性研究1991年1月至2002年6月实施根治性肝切除、且随访和临床资料完整的234例肝细胞癌(HCC)患者的临床资料,Logistic单因素和多因素回归分析PVTT形成与18个常见临床因素的相关性。结果234例患者的P、邢发生率为15%(35/234),Logistic单因素回归分析发现PVTT形成的相关因素为:年龄(P=0.016)、谷氨酰转肽酶(GGT,P=0.003)、侵犯肝段数目(P=0.007)、微血管侵犯(P〈0.01)、肿瘤位于S2段(P=0.001)、S3段(P〈0.01)、S4段(P=0.004)、S6段(P=0.016);Logistic多因素回归分析发现PVTT形成独立相关因素为:年龄(RR:0.373;95%CI:0.146~0.954;P=0.040)、肿瘤位于S3段(RR:4.625;95%C1:1.916~11.165;P=0.001)、微血管侵犯(RR:20.912;95%CI:4.745~92.172;P〈0.01)、GGT(RR:4.091;95%CI:1.448~11.553;P=0.008)。结论PVTT多发生于年龄〈50岁、肿瘤位于第Ⅲ段、GGT升高、显微镜下可见微血管侵犯的HCC患者。
Objective To investigate the related factors of portal vein tumor thrombosis (PVTT) in patients with HCC. Methods A total number of 234 patients with hepatocellular carcinoma (HCC) were included in this retrospective study. Uni-variate and multi-variate logistic regression analysis were employed to analyze the association between PVTT and 18 routine clinical parameters. Results Among the 234 patients with HCC, 15% of patients( 35/235 ) had PVTT. Univariate logistic regression analysis revealed significant association of age ( P = 0. 016 ), gamma glutamyl transferase ( GGT, P = 0. 003 ), number of segmental invasion ( P = 0. 007 ), microvascular invasion ( P 〈 0. 01 ), segment location of S2 ( P = 0. 001 ), S3 (P = 0. 000 ), S4 ( P = 0. 004 ) and S6 ( P = 0. 016 ). Multivariate analysis shows potential significant predictors of PVTT in HCC were age( RR :0. 373 ;95% CI:0. 146-0. 954;P = 0. 040), the tumor location of S3 ( RR :4. 625 ;95 % CI : 1.916-11.165 ; P = 0. 001 ), GGT ( RR : 4. 091 ; 95 % CI : 1. 448-11. 553 ; P = 0. 008 ) and microvascular invasion( RR:20. 912 ;95% CI:4. 745-92. 172;P 〈 0. 01 ). Conclusions PVTT occurred more commonly in the younger( 〈50 years old) ,and those with high level of GGT,segment location of S3 and microvascular invasion.