新疆维汉族非乙非丙型肝癌预后影响因素分析  

Prognosis and influencing factors of non-B and non-C hepatocellular carcinoma in Han and Uighur nationality of Xinjiang

作　　者：周莎莎[1] 张瑞丽[1] 肖蕾[1] 赵化荣[1] 毛睿[1] 包永星[1] 

机构地区：[1]新疆医科大学第一附属医院肿瘤中心,新疆乌鲁木齐830054

出　　处：《中华肿瘤防治杂志》2014年第1期11-15,共5页Chinese Journal of Cancer Prevention and Treatment

基　　金：新疆维吾尔自治区自然科学基金(2012211A077)

摘　　要：目的:探讨新疆维汉族非乙非丙型原发性肝癌(non-B non-C hepatocellular carcinoma,NBC-HCC)的预后及其影响因素。方法:回顾性分析新疆医科大学第一附属医院肿瘤中心2002-01-01-2012-12-31收治的348例NBC-HCC患者的临床资料。其中汉族277例,维族71例,应用Kaplan-Meier法计算生存率,对可能影响患者预后的因素进行单因素分析,应用Cox比例风险模型进行多因素统计分析。结果:患者6个月和1、3、5年总体生存率分别为58.3%、24.0%、5.5%和2.8%。单因素分析显示,肿瘤的最大直径(P<0.001)、临床分期(P<0.001)、家族史(P<0.001)、门脉癌栓(portal vein tumor thrombus,PVTT,P<0.001)、根治手术(P<0.001)、肝动脉化疗栓塞(transcatheter arterial chemoembolization,TACE,P<0.001)治疗以及TACE+放疗/射频消融(radiofrequency ablation,RAF,P<0.001)治疗与NBC-HCC预后有关。多因素分析显示,临床分期(RR=12.708,P<0.001)、家族史(RR=1.808,P<0.001)、PVTT(RR=2.542,P<0.001)及行TACE治疗(RR=2.487,P<0.001)是影响NBC-HCC患者生存的重要因素。结论:NBC-HCC患者的预后差,具有一定的区域特点及特征。临床分期、合并有PVTT、家族史以及未经TACE治疗是影响患者生存的重要因素。OBJECTIVE：To understand the NBC-HCC patients prognosis,by analyzing the factors that may influence the prognosis of NBC-HCC patients. METHODS：We retrospectively analyzed the clinical data of 348 cases of NBC-HCC patients from 2002-01-01 to 2012-12-31 in First Affiliated Hospital of Xinjiang Medical University,including 277 Han pa- tients and 71 UJgbUr patients： Overall survival for patients were analyzed by Kaplan-Meier method, and the factors that may influence the prognosis and survival of NBC-HCC patients were analyzed using univariate （log-rank test） and multi- variate Cox proportional hazard models. RESULTS： 0. 5-, 1-, 3- and 5-year disease survival rates were 58. 3%, 24. 0%, 5.5 % and 2.8% for all 348 patients, respectively. Univariate analysis by log-rank test showed that the biggest diameter of tumor （P〈0. 001） ,TNM staging system（P〈0. 001）, family history（P〈0. 001）, PVTT（portal vein tumor thrombus, PVTT,P（0. 001）, radical mastectomy （P〈0. 001）, TACE（P〈0. 001） and TACE＋ radiotherapy/RAF（P〈0. 001） were the important factors impacted on the survival of NBC-HCC patients. Multivariate analysis by Cox model showed that TNM staging system （RR = t 2. 708, P （0. 001 ）, family history （ RR = 1. 808, P ： 0.00）, PVTT （ RR ： 2. 542, P = 0.00） and TACE treatment （RR=2. 487, P〈0. 001） were the significant independent prognostic factors. CONCLU- SIONS：The prognosis of NBC HCC is worse,and in Xinjiang region it has certain regional characteristics and features. TNM staging system, portal vein tumor thrombus, family history, and TACE treatment are significant independent factors for survival.

关 键 词：肝肿瘤 非乙非丙型 生存率 预后 危险因素 

分 类 号：R735.7[医药卫生—肿瘤]