影响原发性肝癌TACE疗效的客观预后因素分析

摘要

目的 探讨影响原发性肝癌肝动脉化疗栓塞(TACE)预后的主要因素,为介入治疗的预后评估及干预治疗提供参考.方法 回顾性分析141例行TACE治疗的原发性肝癌患者的临床资料,对可能影响介入治疗预后的因素归类统计,电话咨询随访生存情况,并对临床指标进行单因素及多因素回归分析,找出影响原发性肝癌介入预后独立因素.结果 141例原发性肝癌患者的平均生存时间9.526个月,中位生存时间6.2个月.单因素生存分析筛选治疗次数、肿瘤大小、瘤肝比、分布、个数、包膜、肿瘤血供、动静脉瘘、癌栓、白蛋白、转氨酶、甲胎蛋白(AFP)及碘油沉积程度等指标是与TACE预后相关的影响因素.引入COX比例风险模型,多因素分析显示治疗次数、肿瘤大小、血供、有无动静脉瘘、癌栓及甲胎蛋白水平等为影响TACE介入治疗预后的主要因素(P＜0.05).结论 肿瘤大小、血供、有无动静脉瘘及癌栓、甲胎蛋白水平为影响原发性肝癌介入治疗预后的独立的危险因素,而介入治疗次数是影响介入预后的保护性因素.充分了解影响预后的主要因素,有利于客观评判疗效和生存预期,并提供有效的介入治疗策略.%Objective To analyze the prognostic factors of primary hepatic carcinoma treated with TACE. Methods 141 patients with primary hepatic carcinoma treated with TACE were retrospectively analyzed. Results The average survival time of the patients was 9. 526 months and the median survival time was 6. 2 months. The tumor size, tumor liver ratio, distribution, number, capsule, tumor blood supply, arteriovenous fistula, thrombosis, albumin, transaminase, alpha-fetoprotein (AFP) and the degree of iodized oil deposition TACE were the influencing factors. The multivariate analysis confirmed that frequency of treatment, tumor size, blood supply, with or without arteriovenous fistula, thrombosis, and AFP level were the main factors involved in prognosis (P<0. 05). Conclusion Tumor size, blood supply, with or without arteriovenous fistula thrombosis, AFP level of intervention influence the prognosis of primary liver cancer.