不同方案治疗直径小于10cm肝细胞癌合并门静脉癌栓患者影响生存率的观察

目的：探讨两种不同方案治疗直径小于10cm肝细胞癌合并门静脉癌栓患者影响生存率。方法：将我院100例直径小于10cm肝细胞癌合并门静脉癌栓患者按照抽签法随机地均分为A、B两组，A组行单纯肝动脉插管化疗栓撒（TACE）治疗，B组肝癌手术切除联合癌栓切除＋TACE术，比较两组患者治疗前后DLIA蛋白与VEGF蛋白阳性表达率、五年生存率以及影响患者生存率的因素。结果：（1）A组治疗前后DLL4蛋白与VEGF蛋白阳性表达率差异无统计学意义（P〉0．05），B组治疗前后上述蛋白阳性表达率差异具有统计学意义（P〈0．05，P〈0．01）；（2）根据Kaplan—Meir计算方法，B组五年生存率均明显大于A组（P〈0．001）；（3）经Pearson单因素与COX多因素分析，影响患者预后的危险独立因素为肿瘤大小与手术方式。结论：综合治疗方案用于治疗直径小于10cm肝细胞癌合并门静脉癌栓患者之中，疗效显著，患者五年生存率明显提高。

Different Treatment Regimens Diameter Less Than 10 cm in Patients with Hepatocellular Carcinoma with Portal Vein Tumor Effects Observed Survival

Objective： To investigate the treatment of two different diameters less than 10cm hepatocellular carcinoma patients with portal vein tumor thrombus affect survival. Methods： 100 cases of patients with portal vein tumor thrombus who were less than 10era in diameter to stay in our hospital were randomly divided into A, B groups. Group A was given simple hepatic arterial line insertion tube chemotherapy bolt Caesar （TACE） treatment, and group B was given liver resection surgery combined embolus removal ＋ TACE. VEGF protein DLL4 protein expression rate between the two groups before and after treatment, five-year survival rate and affect patient survival factors were observed. Results： （1） A group of DLL4 protein before and after treatment with VEGF protein expression was no significant difference （P〉 0.05）, B group before and after treatment of the protein expression difference was statistically significant （P 〈0. 05, P 〈0.01 ）; （2） calculation method based on Kaplan-Meir, B group was significantly greater than the five-year survival a group （P 〈0. 001）; （3） by Pearson univariate and COX multivariate analysis, independent prognostic risk factors tumor size and surgery. Conelttsions： Comprehensive treatment programs for the treatment of hepatocellular carcinoma less than 10cm in diameter with portal vein thrombosis among patients, had a significant effect, and five-year survival rate was significantly improved in patients.