目的:探讨影响肝细胞性肝癌(HCC)复发的危险因素,为预测和预防HCC的复发提供依据。方法:通过相关检索策略查找已经发表的针对我国HCC复发危险因素的相关文献,整理并制作成数据库进行Meta分析。结果:HCC患者术后1年复发率为38.7%、2年复发率为57.9%。各因素与HCC术后复发关系的Meta分析结果分别为:乙肝病毒感染(OR=1.53,95%CI:1.12~2.10)、肿瘤直径(〉5 cm)(OR=2.39,95%CI:1.64~3.49)、肿瘤数目(≥2个)(OR=3.57,95%CI:2.15~5.93)、肿瘤包膜不完整(OR=2.61,95%CI:1.17~5.80)、血管侵犯(OR=4.03,95%CI:1.92~8.43)、TNM 3~4期(OR=4.88,95%CI:1.36~17.57)。结论:乙肝病毒感染、肿瘤直径、肿瘤数目、肿瘤包膜、血管侵犯、TNM分期均与HCC术后复发相关,可能是引起HCC复发的危险因素。
Objective: To investigate the risk factors in recurrence of hepatocellular carcinoma,and provide the basis for prediction and prevention of hepatocellular carcinoma recurrence.Methods: We searched the published papers on the risk factors of hepatocellular carcinoma recurrence in China and arranged into a database.Then,Meta-analysis was performed to evaluate the data.Results: The recurrence rates of hepatocellular carcinoma patients were 38.7% after one year of operation,and 57.9% after two years of operation.Meta-analysis of the relationship between the risk factors and hepatocellular carcinoma recurrence was as follows: hepatitis B virus(HBV) infection(OR=1.53,95%CI:1.12~2.10),tumor size(5 cm)(OR=2.39,95%CI: 1.64~3.49),the number of tumor(≥2)(OR=3.57,95%CI: 2.15~5.93),incomplete tumor capsule(OR=2.61,95%CI: 1.17~5.80),vascular invasion(OR=4.03,95%CI: 1.92~8.43),and TNM stage of 3~4(OR=4.88,95%CI: 1.36~17.57).Conclusions: The factors,such as HBV infection,tumor size,the number of tumor,tumor capsule,vascular invasion and TNM stage,are the risk reasons associated with hepatocellular carcinoma recurrence.