行TACE治疗后原发性肝细胞癌患者预后的影响因素
Prognostic Factors of Patients with Primary Hepatocellular Carcinoma Treated with TACE
-
摘要: 目的 探讨行TACE术后的原发性肝细胞癌患者预后的影响因素。方法 回顾性分析2006年3月至2009年10月于云南省肿瘤医院介入医学科就诊的108例原发性肝细胞癌 (HCC) 患者临床资料, 通过建立Cox回归模型, 探究各因素对行TACE治疗的HCC患者预后的影响。结果 Cox回归模型显示, TACE次数对HCC患者的生存情况影响的P值为0.007<0.05, 具有统计学差异, 行多次TACE术者的生存风险为行单次TACE术者的0.465倍;癌灶分布于肝左右叶P值为0.016, 生存风险较单分布于肝左或肝右叶高;NLR>3.97者P值约为0.05。结论 TACE次数、癌灶分布情况、NLR对行TACE治疗HCC患者的生存情况有显著影响。Abstract: Objective To investigate the prognostic factors of primary hepatocellular carcinoma (HCC after TACE1. Methods The clinical data of 108 patients with primary hepatocellular carcinoma (HCC) from March 2006 to October 2009 in the Department of Interventional Medicine of Yunnan Cancer Hospital were analyzed retrospectively. The Cox regression model was established to explore the influence of various factors on the prognosis of HCC patients treated with TACE. Results The Cox regression model showed that the number of TACE had a significant effect on the survival of HCC patients (P < 0.05) , and the survival risk of the patients undergoing multiple TACE operations was significantly lower than that of the control group. P value of whose cancer located in the whole liver was 0.016, and the survival risk was higher than those distributed only in one liver lobe. P value of NLR> 3.97 was 0.050. Conclusion The number of TACE and the distribution of cancer foci have significant effect on the survival of HCC patients treated with TACE.
-
Key words:
- Hepatocellular carcinoma /
- TACE /
- Prognosis /
- Cox regression model
-
[1] [1]ELSERAG HB AND RUDOLPH KL. Hepatocellular carcinoma:epidemiology and molecular carcinogenesis[J].Gastroenterology, 2007, 132 (7) :2557-2576 [2] [2]RAOUL J L, SANGRO B, FORNER A, et al. Evolving strategies for the management of intermediate-stage hepatocellular carcinoma:available evidence and expert opinion on the use of transarterial chemoembolization[J].Cancer Treat Rev, 2011, 37 (3) :212-231. [3] [3]LLOVET JM, BRUIX J. Systematic review of randomized trials for unresectable hepatocellular carcinoma:chemoembolization improves survival[J]. Hepatology, 2003, 37 (2) :429-442. [4] [4]BURREL M, REIG M, FORNER A, et al. Survival of patients with hepatocellular carcinoma treated by transarterialchemoembolisation (TACE) using Drug Eluting Beads. Implications for clinical practice and trial design[J]. J Hepatol, 2012, 56 (6) :1330-1335. [5] [5]SALEM R, LEWANDOWSKI R J, MULCAHY M F, et al.Radioembolization for hepatocellular carcinoma using Yttrium-90 microspheres:a comprehensive report of long-term outcomes[J]. Gastroenterology, 2010, 138 (1) :52-64. [6] [6]FARAZI P A, DEPINHO R A. Hepatocellular carcinoma pathogenesis:from genes to environment[J]. Nature Reviews Cancer, 2006, 6 (9) :674-687. [7] [7]BRUIX J, RAOUL J-L, SHERMAN M, et al. Efficacy and safety of sorafenib in patients with advanced hepatocellular carcinoma:subanalyses of a phase III trial[J]. J Hepatol, 2012, 57 (4) :821-829. [8] [8]MALAGARI K, CHATZIMICHAEL K, ALEXOPOULOU E, et al. Transarterial chemoembolization of unresectable hepatocellular carcinoma with drug eluting beads:results of an open-label study of 62 patients[J]. Cardiovasc Intervent Radiol, 2008, 31 (2) :269-280. [9] [9]LLOVET J M, REAL M I, MONTA A X, et al. Arterial embolisation or chemoembolisation versus symptomatic treatment in patients with unresectable hepatocellular carcinoma:a randomised controlled trial[J]. The Lancet, 2002, 359 (9319) :1734-1739. [10]袁维国.肝细胞肝癌肝切除术前TACE对预后影响的Meta分析[J].中国肿瘤外科杂志, 2010, 02 (5) :282-287. [11]杨可立, 陈锦滨, 朱应钦, 等.炎症预后评分与肝癌射频消融术预后的相关性[J].广东医学, 2018, 39 (15) :2294-2299. [12]张劲夫, 范正军, 梁润威, 等.术前SIRI和PLR对肝癌切除术后病人生存预测价值分析[J].中国实用外科杂志, 2018, 38 (2) :210-218. [13]何朝滨, 林小军.中性粒细胞/淋巴细胞比值血小板/淋巴细胞比值与TACE治疗肝癌患者预后的相关性[J].中国肿瘤临床, 2017, 44 (6) :283-288. [14]郑游冰, 赵炜, 刘冰, 等.中性粒细胞-淋巴细胞比值预测肝细胞癌患者TACE术后预后[J].中国介入影像与治疗学, 2013, 10 (9) :523-526. [15]张溪.影响BCLC C期肝细胞肝癌患者行TACE治疗预后因素的分析[D].上海:复旦大学, 2013.
点击查看大图
计量
- 文章访问数: 2748
- HTML全文浏览量: 1020
- PDF下载量: 58
- 被引次数: 0