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目的：探讨影响肝细胞癌患者根治性术后预后相关因素。方法：回顾性分析2004 年1月1 日至2009 年12 月31 日245 例我院行根治性切除术的肝细胞癌患者，采用Kaplan-Meier 法和Cox 比例风险模型分析临床资料、手术过程、病理特征与预后的关系。结果：多因素分析结果显示术前AFP 水平、术中出血量、TNM分期是影响无进展生存时间和总生存时间的独立风险因素。术前AFP 水平越高、术中出血量越大、TNM分期越晚则患者无进展生存时间及总生存时间明显缩短。此外，患者出现肿瘤组织局部坏死、门静脉癌栓，则总生存时间明显缩短。结论：术前AFP水平、术中出血量、TNM 分期是外科根治性切除术后肝细胞癌患者复发及死亡的相关因素，对于临床医师判断预后及延长术后生存时间具有重要的临床意义。

英文摘要:

Objective:To explore the prognostic factors of curative resection in patients with hepatocellular carcinoma.Methods:The clinicopathologic data of 245 cases with hepatocellular carcinoma who had received curative resection in our hospital from January 1, 2004 to December 31, 2009 were analyzed retrospectively. The correlation of clinicopathologic factors and surgical factors with prognosis were analyzed by Kaplan-Meier method and Cox proportional hazard model.Results:Multivariate analysis showed that preoperative AFP level, intraoperative blood loss and TNMstaging were the independent risk factors for disease-free survival and overall survival. Patients with advanced TNMstage, higher preoperative AFP level or greater intraoperative blood loss had increased risk of poor disease-free survival and overall survival. In addition, patients with tumor partial necrosis and portal vein tumor thrombosis had increased risk of poor overall survival.Conclusion:Preoperative AFP level, intraoperative blood loss and TNM staging are the recurrence and death correlation factors of hepatocellular carcinoma who receive curative resection, which are important in prognosis and prolong survival time for clinicians.

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