超声引导下微波消融治疗不同年龄段原发性肝癌生存分析  

Survival Analysis of Primary Liver Cancer in Different Age after Ultrasound-guided Microwave Ablation

作　　者：王建彬[1] 梁萍[1] 于晓玲[1] 程志刚[1] 于杰[1] 于明安[1] 刘方义[1] 

机构地区：[1]中国人民解放军总医院介入超声科,北京100853

出　　处：《医学研究杂志》2013年第8期23-26,共4页Journal of Medical Research

基　　金：国家科技部科技支撑计划基金资助项目(2013BAI01B01);国家科技部国际合作基金资助项目(2012DFG32070)

摘　　要：目的探讨超声引导下微波消融治疗不同年龄段原发性肝癌患者生存状态。方法选取于2008年1月1日～2010年7月31日间行超声引导下微波消融治疗的原发性肝癌患者,按年龄≤45岁、46～64岁、≥65岁将患者分为青年组、中年组和老年组,复发、转移及生存率采用Cox多因素回归分析。结果总共入组336例,失访31例,随访时间为24～55个月。3组在性别、病灶数目、病灶大小、最大直径、基础肝病类型、病理分化程度、Child-pugh分级、失访率等方面无差异,治疗后住院天数、主要不良反应及并发症方面亦无显著差异(P>0.05)。青年组、中年组、老年组的总的复发、转移率分别为57.1%(32/56)、64.5%(118/183)、65.2%(43/66);总的病死率分别为25.0%(14/56)、30.1%(55/183)、28.8%(19/66)。多因素Cox回归分析表明,3组的无病生存及总生存情况无显著差异(P>0.05)。结论超声引导下微波消融治疗适合各年龄段的原发性肝癌患者,对于高龄、一般状况不能耐受手术和肝脏代偿功能不佳的患者,微波消融治疗相对安全,但需根据适应证和禁忌证对患者进行全面评估。Objective To study the survival of different age patients with primary liver cancer after ultrasound - guided percutaneous microwave ablation treatment. Methods From January 2008 to July 2010, all patients with primary liver cancer were received the ultra- sound - guided percutaneous microwave ablation therapy. The groups were classified as three groups by age. Results In all 336 patients, 31 of them were lost to follow - up. There was no significant difference between three groups on gender, the number of lesions, lesion size, the maximum diameter, the type of liver disease, tumor differentiation, Child - Pugh classification, adverse reactions and complica- tions（P 〉 0.05 ）. The recurrence and metastasis rate of young group, middle- aged group, and elderly group were 57. 1% （32/56）, 64.5%（118/183）, 65.2% （43/66）, respectively. The mortality rates of the three groups were 25.0% （14/56）, 30. 1% （55/183）, 28.8% （19/66）. Multivariable Cox regression analysis showed that there was no significant difference among three groups in disease -free survival and overall survival（P 〉 0.05）. Conclusion Ultrasound - guided percutaneous microwave ablation therapy suits for primary liv- er cancer patients of different age. But for patients with older age, poorly compensated liver function and who cannot tolerate surgery, mi- crowave ablation is relative safety.

关 键 词：原发性肝癌 微波消融治疗超声引导 年龄 生存分析 

分 类 号：R512.62[医药卫生—内科学]