TACE联合^(125)I粒子植入治疗原发性肝癌伴门静脉癌栓的预后分析  

Transcatheter Arterial Chemoembolization Combined with Iodine-125 Seed Implantation for Hepatocellular Carcinoma with Portal Vein Tumor Thrombus:Prognostic Analysis

作　　者：印于 杨俊[1] 倪才方[1] YIN Yu;YANG Jun;NI Cai-fang(Department of Interventional Radiology,First Affiliated Hospital of Soochow University,Suzhou,Jiangsu,215006,China)

机构地区：[1]苏州大学附属第一医院介入科,江苏苏州215006

出　　处：《中国血液流变学杂志》2024年第1期71-76,共6页Chinese Journal of Hemorheology

基　　金：北京医学奖励基金会(YXJL-2020-0972-0419)。

摘　　要：目的评估经动脉化疗栓塞(TACE)联合^(125)I粒子植入治疗原发性肝癌伴门静脉癌栓(PVTT)预后,探索其相关预后因素。方法回顾性分析在2016年1月—2019年12月行TACE联合^(125)I粒子植入治疗的原发性肝癌伴PVTT患者,建立病例资料数据库,对相关因素采用Kaplan-Meier检验进行生存率的单因素分析,Cox风险回归模型多因素分析得出独立预后因子。结果该研究共纳入57例患者,6、12、18和24个月的生存率分别为71.9%、45.6%、23.4%和17.5%,中位生存时间为9.5个月。多因素分析得出4个独立影响因素:肿瘤最大径(HR 2.487,95%CI:1.242~4.978)、PVTT分型(HR 1.886,95%CI:1.177~3.019)、动门脉瘘(HR 5.165,95%CI:2.130~12.525)、PVTT反应率(HR 2.087,95%CI:1.503~2.899),4个因素对生存期的影响差异均有统计学意义(P<0.05)。结论影响TACE联合^(125)I粒子植入治疗原发性肝癌伴PVTT患者的独立预后因子为肿瘤最大径、PVTT分型、动门脉瘘及PVTT反应率。Objective To evaluate the prognosis of transcatheter arterial chemoembolization(TACE)combined with ^(125)I seed implantation in the treatment of primary hepatocellular carcinoma with portal vein tumor thrombus(PVTT),and explore the related prognostic factors.Methods A retrospective analysis was performed on patients with primary hepatocellular carcinoma with PVTT who received TACE combined with ^(125)I seed implantation from January 2016 to December 2019.A case data database was established,and Kaplan-Meier test was used for univariate analysis of survival rate for related factors.Multivariate analysis of Cox risk regression model revealed independent prognostic factors.Results A total of 57 patients were enrolled in this study,and the survival rates at 6,12,18 and 24 months were 71.9%,45.6%,23.4%and 17.5%,respectively,with a median survival time of 9.5 months.Multivariate analysis showed that there were four independent influencing factors:maximum tumor size(HR 2.487,95%CI:1.242-4.978),PVTT type(HR 1.886,95%CI:1.177-3.019),arterialportal-shunt(HR 5.165,95%CI:2.130-12.525),PVTT response rate(HR 2.087,95%CI:1.503-2.899),and the above four factors on survival were statistically significant(P<0.05).Conclusion The independent prognostic factors influencing TACE combined with ^(125)I seed implantation in patients with primary hepatocellular carcinoma with PVTT were tumor size,PVTT typing,arterial-portal-shunt and PVTT response rate.

关 键 词：原发性肝癌 门静脉癌栓 肝动脉化疗栓塞 ^(125)I粒子 预后分析 

分 类 号：R735.7[医药卫生—肿瘤]