原发性肝癌肝动脉化疗联合射频消融术后复发的相关因素分析  

Factors affecting the recurrence of primary liver cancer treated by hepatic artery chemotherapy combined with radiofrequency ablation

作　　者：韩纲[1] 白波[1] 韩玉华[1] Han Gang;Bai Bo;Han Yuhua(Department of Hepatology,the Fourth People’s Hospital of Datong,Datong 037008,China)

机构地区：[1]山西省大同市第四人民医院肝病科,037008

出　　处：《中国实用医刊》2020年第2期19-21,共3页Chinese Journal of Practical Medicine

基　　金：山西省大同市科技基金立项课题(016087)。

摘　　要：目的分析原发性肝癌患者采用肝动脉化疗栓塞术联合射频消融术治疗后复发的相关因素。方法抽取2013年1月至2017年1月于大同市第四人民医院行肝癌化疗栓塞术联合射频消融术治疗的原发性肝癌患者85例,治疗后随访3、6、12、24个月,记录肿瘤复发率,分析诱发肿瘤复发的影响因素。结果随访24个月,经肝动脉化疗联合射频消融术治疗后3、6、12、24个月的复发率分别为8.24%、11.76%、15.29%、23.53%。单因素分析显示,复发患者性别、年龄与未复发患者比较,差异未见统计学意义(P>0.05);复发患者肿瘤大小、Child-Pugh分级、肿瘤数目、大血管侵犯、TNM分期与未复发患者比较,差异有统计学意义(P<0.05);经Logistic多因素分析显示,肿瘤长径≥6 cm、Child-Pugh分级B级、肿瘤数目>2个、大血管侵犯、TNM分期为Ⅲ~Ⅳ期是导致术后复发的危险因素(OR>1,P<0.05)。结论肝动脉化疗联合射频消融术治疗原发性肝癌后复发率明显降低。肿瘤长径≥6 cm、Child-Pugh分级B级、肿瘤数目>2个、大血管侵犯、TNM分期为Ⅲ~Ⅳ期是导致术后复发的危险因素。Objective To analyze the factors affecting recurrence of primary liver cancer treated by hepatic artery chemoembolization combined with radiofrequency ablation.Methods A total of 85 patients with primary liver cancer treated by chemotherapy embolization combined with radiofrequency ablation in the Fourth People’s Hospital of Datong from January 2013 to January 2017 were selected as research objects. All patients were followed up for 3, 6, 12 and 24 months after treatment. The recurrence rate of tumor was recorded, and the influencing factors of tumor recurrence were analyzed.Results The recurrence rate was 8.24% at 3 months, 11.76% at 6 months, 15.29% at 12 months and 23.53% at 24 months. Univariate analysis showed that there was no statistically significant difference in the gender and age of patients with recurrence and those without recurrence (P>0.05). There were statistically significant differences in tumor major diameter, Child-Pugh grade, tumor number, vascular invasion and tumor, node and metastasis (TNM) stage between patients with recurrence and those without recurrence (P<0.05). The Logistic multifactor analysis showed that tumor major diameter more than 6 cm, Child-Pugh grade of B, tumor number more than 2, vascular invasion, TNM stage for Ⅲ - Ⅳ were the risk factors of postoperative recurrence (OR> 1, P<0.05).Conclusions Hepatic arterial chemotherapy combined with radiofrequency ablation in treatment of primary liver cancer can significantly lower recurrence rate. Tumor major diameter more than 6 cm, Child-Pugh grade of B, tumor number more than 2, vascular invasion, TNM stage for Ⅲ - Ⅳ are the risk factors of postoperative recurrence.

关 键 词：原发性肝癌 肝动脉化疗栓塞术 射频消融术 

分 类 号：R735[医药卫生—肿瘤]