影响肝切除术后行TACE 患者预后因素的分析

目的:对原发性肝细胞肝癌(HCC)肝部分切除术后行经肝动脉化疗栓塞(TACE)的病人和未行TACE病人影响其预后的多种因素进行分析和评价,为肝切除术后是否行TACE治疗寻找筛选条件。方法:对我院2003～2008年期间在我院肝胆外科行原发性肝细胞肝癌手术治疗221例(术后介入治疗103例,术后非介入治疗118例)患者进行全面随访了解患者的预后情况,分别对术后接受介入治疗和非介入治疗两组通过Kaplan-Meier及COX回归分析影响预后的因素,包括:年龄、性别、血清HBsAg、肿瘤直径、肿瘤大体分型、有无癌栓形成,肿瘤分期(TNM)共7项指标。结果:在1年生存期内介入治疗组中的性别、年龄、血清HBsAg、肿瘤直径、肿瘤大体分型无统计学意义(p>0.05),有无癌栓形成及肿瘤分期有意义(p<0.05);非介入组内年龄、性别、血清HBsAg无统计学意义,肿瘤直径、肿瘤大体分型、有无癌栓形成,肿瘤分期有意义;在3年生存期内介入治疗组中的以上指标无统计学意义,而非介入组在肿瘤直径、有癌栓形成及肿瘤分期方面与统计学意义。结论:对于肿瘤直径>5cm及术后病理证实为低分化的患者给予积极TACE治疗可明显提高近期生存率。

Analysis of Prognostic Factors Affecting Patients Receiving TACE after Liver Resection Surgery

Objective: To find filtering conditions for conducting TACE treatment after liver resection surgery by analyzing and evaluating various prognosis factors affecting patients receiving TACE and not receiving TACE after having partial hepateetomy of primary hepatocellular carcinoma (HCC). Methods: To analyze the prognosis of 221 patients (103 received postoperative interventional therapy and 118 received postoperative non-interventional treatment) receiving primary HCC surgery treatment in our hospital during the period from 2003 to 2008. And analyze the factors affecting prognosis in the group receiving interventional therapy after surgery and thegroup receiving non-interventionai treatment after surgery via Kaplan-Meier and COX regression, which include age, gender, serumHBsAg, tumor size, tumor gross type, with or without eancerembolus formation, and Tumor stage (TNM). Results: In one-year survival period in the intervention group, age, sex, serum HBsAg, tumor size, and tumor gross type had no statistical significance (p>0.05), whilewith or without eaneerembolus formation, tumor stage were meaningful (p<0.05); In the non-intervention group, the age, sex, serum HBsAg had no statistical significance, while the tumor size, tumor gross type, with or without cancerembolus formation, and tumor stage were meaningful; In three-year survival period in the intervention group, indexes above had no statistical significance, but in the intervention group, tumor size, with or without caneerembolus formation, and tumor stage had statistical meaning. Conclusion: Giving positive TACE treatment to patients whose tumor are bigger than 5em and are proved poorly differentiated by postoperative pathology can significantly improve their recent survival rate.