The Clinical Analysis Of The Risk Factors For The Primary Liver Carcinoma With Portal Vein Tumor Thrombus

Objective To investigate the relevant factors of the Primary LiverCarcinoma(PLC) patients with PVTT. Based on the analysis of therelationship between the high level Alpha-Fetoprotein(AFP) with PortalVein Tumor Thrombus(PVTT) in Hepatic Carcinoma(HCC)，the high levelAFP could become one of the factors for the PLC patients to prognosis thedevelopment of PVTT.Since,we could detect and treat the PVTT earlier，and make a better prognosis.Methods Retrospective analysis of the PLC patients chosen atrandom in the department of hepatobiliary surgery of the First AffiliatedHospital of Chongqing Medical University from April2009to April2011，the total case number were133. We observed the level of the AFP（400ng/ml is the dividing line），with or without PVTT,tumor size,tumornumber,gender and vascular invasion.The statistical method：we used thethe chi-square test and non-conditional logistic regression analysis.Results There were four bile duct cell cancer patients，one gastricstromal tumor liver metastases patient，two hepatic metastasis of colonic carcinoma patients in the133patients.Other126patients wereHCC.56patients（44.4%）were diagnosised as HCC with PVTT.vascularinvasion,tumor size,high level AFP,tumor number were the risk factors ofPVTT development(χ~2=20.97，13.67，4.73,5.04， P＜0.0). vascularinvasion,tumor size were the risk factors of AFP（χ~2=8.121,4.038，P＜0.05）,then used the non-conditional logistic regression to analysis multiplefactors.AFP, vascular invasion were the independent risk factors of thePVTT.Conclusions We found that the serum AFP level could reflectvascular invasion and tumor size in the HCC patients，whereas thevascular invasion and tumor size were the relevant factors of thePVTT.When the level of AFP increased significantly（＞400ng/ml）,thepossibility of PVTT development would be high. So the high level AFPcould become one risk factor of the HCC patients developed PVTT. Thismarker could help to guide the clinical work and detect or treat the PVTTearlier.