原发性肝癌的介入治疗及其预后的影响因素  

Prognostic factors of primary hepatic carcinoma patients treated by interventional therapy

作　　者：喻建华[1] 万会平[1] 

机构地区：[1]江西省人民医院肿瘤科,江西南昌330006

出　　处：《肿瘤防治杂志》2004年第12期1309-1312,共4页China Journal of Cancer Prevention and Treatment

摘　　要：目的 :评价肝动脉灌注化疗栓塞 (TACE)对原发性肝癌的疗效 ,并对影响疗效的多种因素进行分析。方法 :1995年 1月～ 2 0 0 1年 1月对 90例肝癌患者行肝动脉介入治疗。 2 4例单纯肝动脉灌注化疗 (TAI) ,66例肝动脉灌注化疗加碘油栓塞 (LP TACE)。分析其生存率与治疗方法、次数、门脉癌栓、肿瘤分型、肿瘤大小、肝功能Child分级及临床分期的关系。结果 :1)全组 1、2、3、4、5年生存率分别为 5 0 0 %、2 6 7%、16 7%、3 3 %、1 1%。TACE组 1、2、3、4、5年生存率分别为 5 9 1%、3 1 8%、2 2 7%、4 5 %、1 5 % ;TAI组 1、2年生存率分别为 2 5 0 %、12 5 % ,无存活 3年者。TACE组疗效较好 ,P <0 0 1;2 )生存期与治疗次数呈正相关 ,P <0 0 1;3 )门脉内无癌栓者的生存率显著高于门脉内有癌栓者 ,P <0 0 5 ;4)单结节型生存率最高 ,弥漫型最差 ,P <0 0 1;瘤径≤ 5cm者疗效最好 ,P <0 0 1;5 )肝功能ChildA级者疗效较好 ,P <0 0 5 ;6)Ⅰ期生存率最高 ,Ⅲ期最差 ,P <0 0 1。结论 :肝癌介入治疗的远期疗效与治疗方法、次数、门脉癌栓、肿瘤分型、肿瘤大小、肝功能Child分级、临床分期密切相关 。OBJECTIVE: To evaluate the curative effect of transhepatic artery chemoembolization (TACE) in patients with primary hepatic carcinoma (PHC), and to analyze the prognostic factors.METHODS:From Jan.1995 to Jan.2001,90 patients with PHC were treated by interventional therapy, 24 patients by transhepatic arterial infusion (TAI) alone,66 patients by TACE using lipidol (LP-TACE).The correlations between the survival rates and therapeutic method and times,tumor type and size, tumor thrombus in portal vein, Child classification and clinical stage were analysed. RESULTS: 1) Overall cumulative survival rates at 1,2,3,4 and 5 years were 50.0%, 26.7%, 16.7%,3.3% and 1.1%, respectively. The survival rates of patients treated by TACE at 1,2,3,4 and 5 years were 59.1%, 31.8%, 22.7%, 4.5% and 1.5% respectively, while those of patients treated by TAI at 1 and 2 years were 25.0% and 12.5%, respectively,and no case had survived over 3 years. The curative effect of TACE was superior to TAI,P<0.01. 2)survival periods were positive correlation with therapeutic times,P<0.01. 3) The survival rates of patients without tumor thrombus in portal vein system were significantly higher than those of patients with tumor thrombus, P<0.05. 4)The survival rates were higher in cases of single nodular type than those in cases of diffuse type,P<0.01. The curative effect of patients with tumor diameter ≤5 cm was best, P<0.01. 5)The curative effect of cases of Child grade A was better than Child grade B, P<0.05. 6)The survival rates were higher in cases of clinical stageⅠB than those in cases of clinical stageⅢA,P<0.01.CONSLUSIONS:The long-term effect of interventional therapy in patients with PHC is correlative with the above mentioned factors.Vigorous and superselective TACE is effective on prolonging survival period.

关 键 词：肝肿瘤/治疗 肝动脉 化学栓塞 治疗性 预后 

分 类 号：R735.7[医药卫生—肿瘤]