引用本文:殷 舞,杨建荣,唐耘天,宋怀宇,李碧锦,许宇彪,林昌荣.Child-Pugh A级肝癌患者癌旁肝组织病理改变与术后肝功能衰竭发生的相关性分析[J].中国临床新医学,2016,9(10):861-864.
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Child-Pugh A级肝癌患者癌旁肝组织病理改变与术后肝功能衰竭发生的相关性分析
殷 舞,杨建荣,唐耘天,宋怀宇,李碧锦,许宇彪,林昌荣
530021 南宁,广西壮族自治区人民医院病理科(殷 舞),肝胆外科(唐耘天),消化内科(宋怀宇);530021 南宁,广西壮族自治区江滨医院普通外科(杨建荣,李碧锦,许宇彪,林昌荣)
摘要:
[摘要] 目的 探讨Child-Pugh A级肝癌患者癌旁肝组织病理改变与术后肝功能衰竭发生的相关性。方法 回顾性分析93例于该院行肝癌根治术的Child-Pugh A级患者癌旁肝组织的病理改变与术后肝功能衰竭发生的相关性及其与术前、术后主要的血清肝功能生化指标的相关性。结果 93例中有18例术后发生肝衰竭,该组病例癌旁肝组织的各项病理学指标以及Knodell总分均与非肝衰竭组间存在统计学差异(P<0.001);术前血清前白蛋白、γ谷氨转肽酶(γ-GT)及碱性磷酸酶(ALP)的表达量在肝衰竭与非肝衰竭组间存在统计学差异(P值分别为0.010、0.000、0.002);癌旁肝组织Knodell总分与术前前白蛋白、γ-GT、ALP相关(P值分别为0.011、0.001、0.026),与术后第7天γ-GT及ALP相关(P值分别为0.004、0.015)。结论 Child-Pugh A级肝癌患者癌旁肝组织的病理学损害程度以及术前血清γ-GT、ALP高表达和前白蛋白低表达均与术后肝功能衰竭的发生密切相关。
关键词:  癌旁组织  病理改变  肝癌  Child-Pugh A级  肝衰竭
DOI:10.3969/j.issn.1674-3806.2016.10.04
分类号:R 735.7
基金项目:广西科学研究与技术开发计划项目(编号:桂科攻12239015)
Correlation between pathological changes of pericancer tissues and posthepatectomy liver failure for hepatocellular carcinoma in patients with Child-Pugh A
YIN Wu, YANG Jian-rong, TANG Yun-tian, et al.
The People′s Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, China
Abstract:
[Abstract] Objective To explore the correlation between pathological changes of pericancer tissues and posthepatectomy liver failure for hepatocellular carcinoma in the patients with Child-Pugh A.Methods The data of 93 patients with Child-Pugh A who underwent liver resection for HCC in our hospital were retrospectively analyzed. The correlation between pathological changes of pericancer tissues and posthepatectomy liver failure and its correlation with serum liver biochemical indexes of preoperation and postoperation were evaluated.Results There were significant differences in the pathological indicators and Knodell scores of pericancer tissues between 18 patients with liver failure and the other patients with no liver failure(P<0.001), and there were significant differences in the levels of preoperative serum prealbumin, γ-GT and ALP between the patients with liver failure and those with no liver failure(P=0.010, 0.000, 0.002). The Knodell scores of pericancer tissues and preoperative serum prealbumin, γ-GT and ALP were correlated(P=0.011, 0.001, 0.026) and they were also correlated with the serum γ-GT and ALP 7 days after the operation(P=0.004, 0.015).Conclusion The degree of pathological damage in pericancer tissues,the high levels of preoperative serum γ-GT and ALP and the low level of prealbumin are closely correlated with the liver failure after hepatectomy.
Key words:  Pericancer tissues  Pathological changes  Hepatocellular carcinoma  Child-Pugh A  Liver failure