Cox模型对肝癌预后因素的分析  

AnalysisofprognosticfactorsusingCox′ smodelinhepatocelularcarcinomatreatedbyinterventionalradiologicaltherapy

作　　者：贾雨辰[1,2] 刘崎[1,2] 贺佳[1,2] 王振堂[1,2] 王飞[1,2] 陈栋[1,2] 孙飞[1,2] 田建明[1,2] 叶华[1,2] 陆建平[1,2] 

机构地区：[1]第二军医大学长海医院放射科 [2]军医大学医学统计教研室工作

出　　处：《中华放射学杂志》1996年第2期80-84,共5页Chinese Journal of Radiology

摘　　要：目的：作者旨在分析原发性肝癌的预后因素，评估不同治疗方法的疗效。材料与方法：应用Ｃｏｘ比例风险模型对经介入治疗的６２１例晚期原发性肝癌进行了回顾性统计分析。根据不同的治疗方法，分为３组：Ａ组，６８例，为单纯动脉内抗癌药物灌注（ＴＡＩ）；Ｂ组，１６８例，碘化油与抗癌药混合化疗栓塞（ＬｐＴＡＣＥ）；Ｃ组，３８５例，ＬｐＴＡＣＥ再加明胶海绵栓塞（ＬｐＧｓＴＡＣＥ）。对三组的生存率作了分析比较。结果：影响肝癌预后最明显的因素是肿瘤大小、门脉内癌栓和治疗方法。６２１例总的生存率１、３、５年分别为６２．２３％、１２．８５％和７．４５％，中位生存期为１６．２３个月。结论：含药碘油和明胶海绵复合性化疗栓塞（ＬｐＧｓＴＡＣＥ）的疗效较ＬｐＴＡＣＥ或单纯ＴＡＩ为好。了解肝癌的预后因素对选择与处理病人是有益的。Purpose:Toanalysetheprognosticfactorsofhepatocelualarcarcinoma(HCC)andtoevaluatetheefectivenessofvarioustranscatheterinterventionalmodalities.MaterialsandMeth-ods:UsingtheCox′sproportionalhazardmodel,weretrospectivelyandstatisticalyanalysed621casesofunresectablelateHCCtreatedwithtranscatheterarterialinfusionorchemoembolizationfrom1986to1992.Accordingtodiferenttherapeuticmethods,thepatientsweredividedintothreegroups:groupA(68cases),intra-arterialinfusion(TAI)alone;groupB(168cases),anticancerdrugsmixedwithlipiodolembolization(LpTACE);groupC(385cases),LpTACEandgelatinsponge(Gs)embolization(LpGsTACE).Thecurativeefectsofthethreegroupswereevaluatedbysurvivalrate.Results:Themostsignificantprognosticfactorsweretumorsize,tumorthrombusintheportalveinandmodalityoftreatment.Theoveralcumulativesurvivalratesfor1,3and5yearswere62.23%,12.85%and7.45%respectively.Themediandurationofsurvivalwas16.23months.Conclusion:TheresultssuggestedthatcombinationtherapyofLpGsTACEwassuperiortoTAIorLpTACE.Furthermore,knowledgeoftheprognosticfactorsisusefulfortheselectionandmanagementofpatients.

关 键 词：细胞瘤 预后 栓塞术 肝肿瘤 COX模型 

分 类 号：R735.707[医药卫生—肿瘤]