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目的：分析肝癌临床各期与术后无瘤生存的关系，探讨肝癌高危人群的确立，以及对该人群肝癌普查的意义。方法：对１７２５例行根治和相对根治性切除的肝癌患者进行回顾性随访，将回访的１４５７例患者的临床病理因素应用ＣＯＸ模型进行单、多因素分析，无瘤生存期（率）采用Ｋａｐｌａｎ－Ｍｅｉｅｒ生存估计法计算。结果：单因素分析表明１２个临床和病理因素影响术后无瘤生存，多因素分析显示术前瘤灶数、瘤灶大小、瘤旁子灶和肝内血管受侵犯与无瘤生存关系密切。亚临床期患者５年的无瘤生存率和中位无瘤生存期明显高于中期和晚期者。结论：对肝癌高危人群普查和其定期行肝脏Ｂ超及ＡＦＰ检查能早期发现肝癌，早期手术延长术后无瘤生存期
Objective: To analyze the relationship between clinical stage and postoperative tumor-free survival of hepatocellular carcinoma (HCC), explore the establishment of a high-risk population for HCC, and the significance of the screening for HCC in this population. METHODS: Retrospective follow-up was performed on 1,725 patients with hepatic carcinoma who underwent radical or relatively radical resection. The clinical and pathological factors of the 1457 patients visited were analyzed by single-factor and multivariate analysis using the COX model. The disease-free survival rate (rate) was Kaplan- Meier survival estimation method is calculated. RESULTS: Univariate analysis showed that 12 clinical and pathological factors affected postoperative disease-free survival. Multivariate analysis showed that the number of preoperative tumors, tumor size, paraneoplastic foci, and intrahepatic vascular invasion were closely related to disease-free survival. The 5-year disease-free survival and median disease-free survival in subclinical patients were significantly higher than those in the mid- and late-stage patients. Conclusions: A general survey of high-risk people with liver cancer and their routine liver ultrasonography and AFP examination can detect early hepatocellular carcinoma, and early surgery can prolong postoperative disease-free survival.