Đánh giá một số đặc điểm tái phát của bệnh nhân sau cắt gan điều trị ung thư tế bào gan=Characteristics of patients with recurrent hepatocellular carcinoma after resection

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Tác giả: Ngọc Hùng Phạm, Công Duy Long Trần

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2024

Mô tả vật lý: tr.51-55

Bộ sưu tập: Metadata

ID: 252658

Thêm vào giỏ

Nghiên cứu nhằm mô tả đặc điểm tại thời điểm tái phát của nhóm bệnh nhân được chẩn đoán tái phát sau cắt gan điều trị ung thư tế bào gan tại bệnh viện trường đại học Y Dược thành phố Hồ Chí Minh từ Tháng 1/2017 – Tháng 6/2022. Đối tượng và phương pháp: đối tượng gồm 238 bệnh nhân tái phát ung thư sau phẫu thuật cắt gan. Phương pháp nghiên cứu: Mô tả 1 loạt ca bệnh hồi cứu. Kết quả và kết luận: Trung vị nồng độ AFP tại thời điểm tái phát là 11 (3-203). 19,3% bệnh nhân có nồng độ AFP ≥ 400 ng/mL. Tỷ lệ tái phát trong nhu mô gan chiếm 95%, 5% không khảo sát thấy tổn thương nhu mô gan. Tính chất u tái phát: tổn thương đa ổ chiếm 58%, 1 u chiếm 37%. Vị trí tái phát: Tổn thương tái phát rải rác nhu mô chiếm 52,9%, tái phát tại diện cắt là 9,7%, tái phát HPT cạnh diện cắt là 18,9%, HPT xa diện cắt là 13,4%. Tình trạng di căn: ghi nhận di căn ở 21,8% bệnh nhân trong đó 5% chỉ di căn ngoài gan, 16,8% vừa tái phát trong gan, vừa di căn ngoài gan. Vị trí di căn: Phổi chiếm tỷ lệ 6,7%, phúc mạc 6,7%, hạch ổ bụng 2,5%, Huyết khối 2,9%, xương 0,4%, di căn nhiều cơ quan 2,5%. Giai đoạn bệnh trước phẫu thuật chủ yếu là BCLC A (65,1%). Tỷ lệ xâm lấn mạch máu đại thể và vi thể lần lượt là 16% và 37,8%.The study was done to describe characteristics of patients with recurent hepatocellular carcinoma the time of surgery at Ho Chi Minh City University of Medicine and Pharmacy from January, 2017 to June, 2022. Subjects and Method: Subjects included 238 patients with recurrent hepatocellular carcinoma after the hepatectomy. Method was a retrospective case series report. Results and conclusions: Median of AFP concentration at the recurrent time was 11 (3-203). 19.3% of patients had AFP ≥ 400 ng/mL. The rate of recurrence in the liver parenchyma accounted for 95% and 5% of patients did not have any liver parenchyma damage. Characteristics of tumor recurrence were multifocal in 58% and in 1 tumor in 37% of patients. Tumor recurrent site scattered in the parenchyma (52.9%), were at the cutting face (9.7%), next to the cutting face (18.9%), and far from the cutting face (13.4%). Recurrence was found tin 21.8% of patients in which 5% was in the liver, 16.8% of patients in the liver and outside the liver. The metastasis in lung accounted for 6.7%, in peritoneum was 6.7%, in abdominal lymph node was 2.5%, thrombosis was 2.9%, in bone was 0.4%, and in multiorgan was 2.5%. The preoperative stage was mainly BCLC A representing 65.1%. The rate of vascular invasion both in macro and in microscopy was 16% and 37,8% respectively.

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