Prognostic factors of hepatocellular carcinoma

By | October 31, 2011

Clinical observations of liver cancer prognostic factors are the following:
Of liver cancer prognosis factors 1. The prognosis of small hepatocellular carcinoma Liver Cancer Institute, Shanghai Medical University, between 1967-1990 there were 314 cases of small hepatocellular carcinoma, 250 cases of surgical resection, 5-year survival was 66.3%, and 10 year survival rate was 48.9% survival up to 22 years, according to TNM staging, is TINoMo 2em and less than a single person per vessel invasion, 5-year survival rate after resection of 100% (n = 15). 3em clinical study found that 5-year survival after hepatectomy was 82.2% (n = 48); Some people think: The prognosis of small hepatocellular carcinoma is also associated with tumor size, number of intrahepatic spread, vascular and capsular assault.
Prognostic factors of liver cancer 2. Prognostic factors of liver cancer in general, although the prognosis of liver cancer is very dangerous, but with improvements in diagnosis and treatment of liver cancer no longer is "incurable." Liver Cancer Institute of Shanghai Medical University hospital, such as patients with liver cancer 5-year survival :1958-1968-year 2.8% (n = 113) ,1969-1979 year 10.5% (n = 404) ,1980-1990 year 36.6% (n = 933), the treatment of advanced hepatocellular carcinoma and a variety of methods in patients with liver cancer will greatly improve the survival rate. But some factors on the prognosis of HCC is indeed related, are:
and clinical manifestations of disease;
molecular biology of tumor characteristics.
Prognostic factors of liver cancer 3. Clinical and Outcomes: Survey discoverer discoverer of prognosis than clinical, subclinical and is superior to the clinical prognosis of patients, and poor clinical prognosis of patients with late period, but in recent years due to surgery and a variety of treatment improved the prognosis of advanced hepatocellular carcinoma is significantly increased, in addition, AFP twenty-three 5000 g / L are usually large tumors and poor prognosis, GGT Note 20U / L (normal 6U / L) were, prognosis is poor. Liver Cancer Institute, Shanghai Medical University, treated 680 cases in 1980-1989, according to TNM stage I patients with the 3-year survival rate of (TINo nap) was 88.2%, II period (TzNo l also) was 60.0%, ill of ( T3Nol also) or (TI-3NIl) was 28.0%, Au a period (T4N a IMo) was 12.1%.
Prognostic factors of liver cancer 4. Pathologic factors and prognosis related to: small liver cancer prognosis is better than large HCC; individual prognosis is better than multiple tumors, encapsulated by a better prognosis, the prognosis is better than the left lobe of the right lobe of liver cancer or bilateral tumor patients. Hepatocellular carcinoma, cholangiocarcinoma, mixed type of liver cancer survival rate no significant difference in the degree of cell differentiation without significant impact on prognosis.
Prognostic factors of liver cancer 5. Treatment of the relevant factors and prognosis: the treatment is very important prognostic factors, resection is superior to non-resection, radical resection and palliative resection is superior. AFP, after the original cut is positive down to normal is to achieve radical resection is an important indicator of prognosis and palliative resection as palliative outside, surgical treatment, but palliative surgical treatment of a single application as a way to the United Application of several methods, coupled with significantly reduced tumor underwent resection of the second phase of the total long-term effect is very good and worth mentioning is the proposed Comprehensive surgical treatment of favorable prognosis of HCC, it is based on advanced liver Cancer of the different situations, using different methods of treatment of liver cancer prognosis may be very different.
6. Tumor molecular biology and prognosis: the development of liver cancer with a variety of cancer genes and cancer genes, studies have shown, p53 gene mutation and stage of liver cancer, portal vein tumor thrombus formation, tumor invasiveness is related to the development of late event in HCC, p21 in differentiation and prognosis of liver cancer, p16 and the recurrence of disease and liver cancer prognosis, p53, p16, p21 can predict outcome as a sign of liver cancer. Androgen can promote liver cancer cell growth and invasion of the surrounding, so the androgen receptor can be used as prognostic indicators of liver cancer, hepatocellular carcinoma transforming growth factor-I-(TBRI) may be reduced expression of TGF-antagonist on liver Malignant evolution of the growth inhibition and the critical factor. TBRI relative expression and the prognosis of liver cancer. Proliferating cell nuclear antigen (PCNA) to determine the prognosis of liver cancer also have some significance, but in the research stage now, still can not influence and determine the liver as a major factor in the prognosis.
In short, the impact of prognostic factors of liver cancer in high incidence surveys and periodic testing in high-risk groups, early detection of subclinical small hepatocellular carcinoma and radical resection for early stage, is to improve the efficacy of important factors. Gradually improve the treatment of liver cancer and regular follow-up. Early detection of recurrence and metastasis and to make further surgery is to improve the long-term outcome after an important way, for a large number of large unresectable hepatocellular carcinoma, the use of multi-mode, integrated sequential therapy, the tumor necrosis, reduced and lost no time for the second phase of removal is an important way to improve liver cancer.

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