CT 联合血清指标对不同组织分化程度肝细胞肝癌患者T ACE 术后的多元分析评价

摘要

Objective To explore evaluation of curative effect on from the combination CT with serum indexes such as diversi‐ty index in different tissue differentiation degree of hepatocellular carcinoma (HCC) that have already accepted the hepatic arte‐rial infusion transcatheter arterial chemo embolization (TACE) .Methods 175 cases of HCC with conventional first before in‐terventional therapy and the clinical data of 4 to 6 weeks after treatment were collected ,including CT effect of judgement ,serum AFP ,liver function and so on ,all of the patients were pathological diagnased as liver cancer after biopsy or surgical removal .Re‐sults According to the results of single factor analysis ,Child‐Pugh grading ,liver function ,AFP concentration ,histological grad‐ing were factors influencing the curative effect of HCC patients .And the clinical curative effect of interventional treatment from different tissue differentiation degree of HCC had different statistically significant ,The efficient of different differentiation of liver cancer patients such as high ,medium and low efficient were 69.1 ,72.5 ,76.8% with respectively ,and low differentiation of liver cancer patients with interventional therapy effect was better .Conclusions TACE in patients with poorly differentiated HCC with conventional had better clinical curative effect ,and the Child‐Pugh grading ,liver function ,AFP concentration were factors influencing the curative effect of HCC patients .%目的：探讨CT联合血清指标等多元指标在不同组织分化程度肝细胞肝癌（hepatocelluar carcinoma ，HCC）行肝动脉灌注化疗栓塞术（transcatheter arterial chemo embolization ，TACE）后疗效评价中的价值。方法收集175例肝细胞肝癌TA‐CE首次介入治疗前及治疗后4～6周的临床资料，包括CT效果情况的判定、血清甲胎蛋白（AFP）、肝功能等，所有患者均经穿刺活检或手术切除病理确诊为肝癌。结果单因素分析结果显示，Child‐Pugh分级、肝功能、AFP浓度、组织学分级是影响HCC患者疗效的因素；不同组织分化程度 HCC介入治疗临床疗效差异有统计学意义，本组研究中高分化、中分化、低分化肝癌患者有效率分别为69.1、72.5、76.8％，低分化肝癌患者介入治疗的效果更好。结论 T ACE对低分化 HCC患者介入治疗有更好的临床疗效，Child‐Pugh分级、肝功能、AFP浓度是影响HCC患者疗效的因素。