术后经导管动脉化疗栓塞对原发性肝细胞癌合并门静脉Ⅰ型癌栓患者预后的影响  

Impact of postoperative hepatic artery chemoembolization on the prognosis of patients with primary hepatocellular carcinoma complicated by type I portal vein tumor thrombus

作　　者：鲁磊[1] 王明锋[2] 叶新平[3] 李伟[1] Lu Lei;Wang Mingfeng;Ye Xinping;Li Wei(Department of Breast and Thyroid Surgery,Beijing Haidian Hospital/Beijing Haidian Section of Peking University Third Hospital,Beijing 100080,China;Department of General Surgery,Beijing Haidian Hospital/Beijing Haidian Section of Peking University Third Hospital,Beijing 100080,China;Department of Hepatobiliary Surgery,the First Affiliated Hospital of Guangxi Medical University,Nanning Guangxi 530021,China)

机构地区：[1]北京市海淀医院/北京大学第三医院海淀院区乳腺甲状腺外科,北京100080 [2]北京市海淀医院/北京大学第三医院海淀院区普通外科,北京100080 [3]广西医科大学第一附属医院肝胆外科,广西南宁530021

出　　处：《中国医刊》2024年第10期1093-1096,共4页Chinese Journal of Medicine

基　　金：广西自然科学基金(2020GXNSFAA159127)。

摘　　要：目的探讨术后经导管动脉化疗栓塞(TACE)对原发性肝细胞癌合并门静脉Ⅰ型癌栓患者预后的影响。方法回顾性纳入2016—2020年在北京市海淀医院及广西医科大学第一附属医院行肝细胞癌合并门静脉Ⅰ型癌栓手术切除的45例患者,其中28例行TACE者作为观察组,17例未行TACE者作为对照组。采用Kaplan-Meier曲线分析两组患者的生存情况,单因素log-rank检验和多因素Cox回归分析探讨影响患者生存时间的独立危险因素。结果单因素log-rank检验显示,年龄、体重指数、术前甲胎蛋白水平、肝硬化、肿瘤直径、巴塞罗那肝癌分期、术后行TACE为肝癌合并门静脉Ⅰ型癌栓患者术后生存时间的影响因素(P<0.05)。多因素Cox回归分析显示,术前甲胎蛋白≥400μg/L为肝癌合并门静脉Ⅰ型癌栓患者术后生存时间的独立危险因素(P<0.05),而体重指数≥24 kg/m2、术后行TACE为其独立保护因素(P<0.05)。结论对伴有门静脉Ⅰ型癌栓的原发性肝细胞癌患者,术后行TACE可延长生存时间,改善预后。Objective To investigate the impact of postoperative transcatheter arterial chemoembolization(TACE)on the prognosis of patients with primary hepatocellular carcinoma(HCC)complicated by portal vein type I cancer thrombus.Method A retrospective study included 45 patients who underwent surgical resection for HCC with portal vein type I cancer thrombus at Beijing Haidian Hospital and the First Affiliated Hospital of Guangxi Medical University from 2016 to 2020.Among them,28 patients received TACE and were assigned to the observation group,while 17 patients did not receive TACE and were assigned to the control group.Kaplan-Meier curves were used to analyze survival between the two groups,and univariate log-rank test and multivariate Cox regression analysis were employed to identify independent risk factors affecting patient survival time.Result The univariate log-rank test indicated that age,body mass index,preoperative alpha-fetoprotein level,liver cirrhosis,tumor diameter,Barcelona Clinic Liver Cancer(BCLC)stage,and postoperative TACE were factors infl uencing the survival time of patients with HCC and portal vein type I cancer thrombus(P<0.05).Multivariate Cox regression analysis revealed that preoperative alpha-fetoprotein level was an independent risk factor(P<0.05),while body mass index and postoperative TACE were independent protective factors(P<0.05).Conclusion For patients with HCC complicated by portal vein type I cancer thrombus,postoperative TACE can prolong survival time and improve prognosis.

关 键 词：肝细胞癌 癌栓 经导管动脉化疗栓塞 生存分析 

分 类 号：R735.7[医药卫生—肿瘤]