TACE对肝癌患者术后疗效及预后的影响因素分析  

Effect of TACE on the prognosis of patients with hepatocellular carcinoma after operation

作　　者：李英锋[1] 蒋寒[1] 尹同治[1] 

机构地区：[1]湖北省潜江市中心医院普外科,湖北潜江433100

出　　处：《中国现代普通外科进展》2017年第6期447-450,共4页Chinese Journal of Current Advances in General Surgery

摘　　要：目的:探讨根治性切除术联合肝动脉化疗栓塞术(TACE)治疗原发性肝癌(PHC)的疗效及预后影响因素分析。方法:回顾性分析2008年1月—2012年1月湖北省潜江市中心医院收治的PHC患者136例作为研究对象,将86例接受根治切除术辅助TACE治疗的患者作为观察组,其余50例行单纯根治切除术治疗的患者作为对照组。比较两组患者治疗6个月后肿瘤标志物癌胚抗原(CEA)、甲胎蛋白(AFP)、CA19-9及谷丙转氨酶(ALT)水平变化;比较两组患者生存情况及分析预后相关因素。结果:治疗6个月后观察组肿瘤标志物CEA、AFP、CA199及ALT水平均显著低于对照组,观察组患者1、2、3年生存率显著高于对照组,差异有统计学意义(P<0.05)。单因素分析显示分化程度、肿瘤直径、淋巴结转移、血管癌栓形成、CA199浓度等因素与PHC患者术后生存期有关(P<0.05);多因素分析结果显示分化程度、淋巴结转移、CA199浓度是影响根治切除术辅助TACE治疗PHC预后的重要因素(P<0.05)。结论:根治切除术联合TACE治疗PHC,临床疗效肯定,可有效提高术后远期生存率,分化程度、淋巴结转移情况、CA199浓度是影响根治切除术辅助TACE治疗PHC预后的重要因素。Objective： To investigate the curative effect and prognostic factors of primary liver cancer（PHC） treated with radical resection combined with transcatheter arterial chemoembolization （TACE）. Methods： A retrospective analysis was used to analyze the clinical data of 136 cases of PHC patients treated in Qianjiang Central Hospital of Hubei Province from January 2008 to January 2012, the 86 cases received raJical resection and postoperative adjuvant TACE treatment of patients as the observation group, and the remaining 50 cases only with radical resection in the treatment of patients were selected as control group. After 6 months of treatment, the level of tumor markers Carcinoembryonic antigen（CEA）, alpha fetoprotein（AFP）, CA199 and alanine aminotransferase（ALT） in two groups were observed and compared. The survival status and prognostic factors of the two groups were compared. Results： After 6 months of treatment, the leve of tumor markers CEA, AFP, CA199 and ALT in the observation group were significantly lower than those in the control group（P〈0.05）; The 1-year, 2-year, and 3-year survival rate of the observation group were significantly higher than those in the control group; Univariate analysis showed that the differentiation degree, tumor size, lymph node metastasis, vascular tumor thrombus, CA199 concentration factors and the observation group patients （radical resection and postoperative adjuvant TACE） postoperative survival period （P〈0.05）; Further multivariate analysis showed that the degree of differentiation, lymph node metastasis and CA199 concentration were the important factors influencing the prognosis of patients with TACE after radical resection （P〈0.05）. Conclusion： Radical resection combined with TACE in the treatment of PHC has well clinical curative effect, which can effectively improve the postoperative long-term survival rate. Degree of differentiation, lymph node metastasis, and CA199 concentration are important factors impacting the radical

关 键 词：原发性肝癌 肝根治切除术 化疗栓塞术 疗效 预后 

分 类 号：R735.7[医药卫生—肿瘤]