肝动脉化疗栓塞治疗原发性肝癌的预后因素分析  

Prognostic factors of TACE treatment in patients with primary hepatic carcinoma

作　　者：刘国起 吴向未[2] 杨宏强[2] 吕海龙[2] 孙红[2] 褚志强[2] 荔童 邱明[1] 马杰[1] 张示杰[2] 

机构地区：[1]石河子大学医学院,新疆石河子832000 [2]石河子大学医学院第一附属医院肝胆外科,新疆石河子832000

出　　处：《现代肿瘤医学》2016年第2期267-270,共4页Journal of Modern Oncology

摘　　要：目的:探讨影响肝动脉化疗栓塞治疗原发性肝癌预后的相关因素,为原发性肝癌患者选择个体化治疗方案及估计预后提供参考。方法:回顾性分析2003年6月-2012年6月石河子大学医学院第一附属医院实施肝动脉化疗栓塞的153例患者的临床资料及随访数据,生存分析采用生命表法,相关因素分析行Logrank检验,多因素分析采用Cox模型,筛选出影响预后的因素。结果:随访至2013年6月30日153例患者失访15例(9.8%),原发性肝癌患者经肝动脉化疗栓塞后1、3、5年生存率分别为55.92%、31.02%、21.18%。单因素分析结果显示肝功能分级、甲胎蛋白(AFP)、肿瘤大小、肿瘤数目、门脉癌栓及治疗次数是影响预后的因素;Cox风险回归分析显示肝功能分级、肿瘤数目、门脉癌栓及治疗次数是影响预后的独立因素(P<0.05)。结论:肝功能分级、肿瘤数目、门脉癌栓为影响原发性肝癌介入治疗预后的独立危险因素,而治疗次数是影响预后的保护性因素。Objective： To study the prognostic factors of transhepatic arterial chemotherapy and embolization（ TACE） in treating primary hepatocarcinoma（ HCC）. Methods： The clinical and follow- up data of 153 cases with TACE were analyzed retrospectively. Survival analysis was used and the life table method,related factor was used for Log-rank test,Cox model was used for multiple- factor analysis. Results： Follow- up until June 30,2013,15 cases of 153 patients were lost to follow- up（ 9. 8%）,the 1- year,3- year,5- year survival rates in 138 cases were 55. 92%,31. 02% and 21. 18% respectively. Single factor analysis showed that influencing factors of prognosis were Child-Pugh,alpha fetal protein（ AFP）,tumor size,the number of tumor,portal vein tumor thrombus（ PVTT） and the number of treatment. Cox regression analysis showed that independent factors of prognosis were Child- Pugh,the number of tumor,the number of treatment,portal vein tumor thrombus（ PVTT）. Conclusion： Independent risk factors of TACE prognosis were Child- Pugh,the number of tumor,portal vein tumor thrombus（ PVTT）,protective factor of TACE prognosis was the number of treatment.

关 键 词：原发性肝癌 肝动脉化疗栓塞 预后 影响因素 

分 类 号：R735.7[医药卫生—肿瘤]