不同残癌危险因素对原发性肝癌术后肝动脉化疗栓塞效果的影响  

Effect of different risk factors of residual tumor on postoperative adjuvant transcatheter arterial chemoembolization for hepatocellular carcinoma

作　　者：张建党[1] 

机构地区：[1]黄河中心医院普外科,郑州450003

出　　处：《中国实用医刊》2011年第18期81-83,共3页Chinese Journal of Practical Medicine

摘　　要：目的通过对影响肝癌术后肝动脉化疗栓塞效果的分析，探讨不同残癌危险因素对肝癌术后肝动脉化疗栓塞患者预后的影响。方法①总结2000年1月至2004年12月我院收治的原发性肝癌手术患者385例的临床、病理资料，其中190例术后行肝动脉化疗栓塞（干预组），195例术后未行肝动脉化疗栓塞（对照组）。②依据肿瘤直径大小、癌灶数、有无门静脉癌栓等残癌危险因素分别将两组患者分为残癌高危组和残癌低危组。干预组与对照组采用病例对照研究分析残癌危险因素对术后肝动脉化疗栓塞（TACE）效果的影响。③用SPSS10．0软件包进行统计分析，d：0．05为检验水准。结果对于残癌低危患者，干预组与对照组1、2、3、4、5年的生存率分别为96．6％、79．7％、67．8％、62．7％、50．8％和93．3％、81．7％、70．0％、56．7％、55．0％，生存率比较差异无统计学意义（P=0．6607）。对于残癌高危患者，干预组与对照组1、2、3、4、5年的生存率分别为87．8％、77．1％、61．1％、51．1％、42．0％和83．7％、66．7％、54．1％、37．8％、27．4％，生存率比较差异有统计学意义（P=0．0101）。结论术后TACE不能提高残癌低危险因素患者的生存期但可提高残癌高危险因素患者的生存期。Objective By means of analyzing the different risk factors of residual tumor of postoperative adjuvant TACE for HCC patients, to take a correct choice for treating the liver cancer patients after hepatectomy. Methods ①From January 2000 to December 2004, 385 patients underwent hepatectomy for HCC were enrolled to review their clinical characteristics, treatment and prognosis, among them190 patients underwent adjuvant TACE after hepateetomy and 195 patients didn＇t undergo adjuvant TACE after hepatectomy. ②All patients were subdivided into two groups with high risk factors （patients with single tumor 〉 5 cm in diameter, or with multiple tumors, or with portal tumor thrombi） and low risk factors（patients with single tumor ≤5 cm, without portal tumor thrombi）. The intervention group and the control group were studied by case - control study.③To deal with it by SPSS 10. 0 soft- ware package on computer based on statistics, a value less than 0.05 was considered as significance. Resuits To the low risk patients with residual tumor, the 1,2,3,4,5 year survival rate （SR） was 96.6%, 79.7% ,67.8% ,62.7% ,50. 8% in the intervention group, and the 1,2,3,4,5 year SR was 93.3%, 81.7% ,70. 0% ,56.3% and 55.0% in the control group. There was no statistical difference between the two groups in survival rate （ P =0. 6607）. To the high risk patients with residual tumor, the 1,2,3,4, 5 year SR was 87.8% ,77. 1% ,61.1% ,51.1% and 42.0% in the intervention group, and the 1,2,3, 4,5 year SR was 83.0% ,66. 7% ,54. 1% ,37.8% and 27.4% in the control group. There was statistical difference between the two groups in survival rate（ P = 0. 0101 ）. Conclusions Postoperative adjuvant TACE can＇ t prolong surving time for the low risk patients with residual tumor, but it can prolong surving time for the high risk patients with residual tumor.

关 键 词：癌 肝细胞 治疗 化学栓塞 预后 

分 类 号：R735.7[医药卫生—肿瘤]