TACE在原发性肝癌伴门静脉癌栓术后治疗中的作用

目的 :研究TACE在原发性肝癌伴门静脉癌栓术后治疗中的作用及影响其疗效的因素。方法 :随访 4 0例原发性肝癌伴门静脉癌栓术后病人 ,其中 2 1例病人术后行TACE治疗。比较两组病人的肿瘤复发时间和生存期。单因素和多因素分析影响术后TACE疗效的因素。结果 :原发性肝癌伴门静脉癌栓单纯手术切除病人的肿瘤平均复发时间 6 .1个月 ,中位生存时间10 .3个月 ,其半年、1、2、3年生存率分别为 4 5 .9%、4 .2 %、0 %、0 %。术后行TACE的病人肿瘤平均复发时间 11.1个月 ,中位生存时间 2 0 .7个月 ,其半年、1、2、3年生存率分别为 6 2 .2 %、5 6 .3%、35 .6 %、2 8.5 % ,明显高于单纯手术病人 (P <0 .0 5 )。单因素分析提示肿瘤大小、细胞分化、化疗栓塞次数是影响术后TACE疗效的主要因素。多因素分析提示细胞分化、化疗栓塞次数影响术后TACE的疗效。结论 :TACE推迟原发性肝癌伴门静脉癌栓术后的肿瘤复发时间 ,延长病人的生存期。肿瘤细胞分化 ,化疗栓塞次数是影响术后TACE疗效的主要因素。

The Effects of TACE on Patients of Primary Liver Cancer with Portal Vein Tumor Thrombi after Surgical Treatment

Objective: To study the effects of TACE and the factors affecting the results in the patients of primary liver cancer (PLC) with portal vein tumor thrombi (PVTT) after surgical treatment. Meth o ds: 40 patients of PLC with PVTT after operation were followed, in wh o m 21 patients were treated with TACE. The time of tumor recurrence and the survi val between the two groups were compared. The factors affecting the effects of T ACE were estimated by univariate and multivariate analysis. Resluts: The mean time of tumor recurrence in the patients only treated with rese c tion was 6.1 months, the median survival time was 10.3 months and the half of ye ar, 1, 2, 3year survival rates were 45.9%, 4.2%, 0% and 0%, respectively. But i n the patients treated with following TACE, the mean time of tumor recurrence wa s 11.1 months, the median survival time was 20.7 months and the half of year, 1 , 2,3year survival rates were 62.2%, 56.3%, 35.6% and 28.5%, respectively, which were significantly higher than the former (P<0.05). Both univariate analys is and multivariate analysis showed that cell differentiation and chemoemblizati on courses affected the results of TACE. Conclusion: TACE po stponed the time of tumor recurrence and prolonged the survival in the patients of PLC with PVTT after resection. Cell differentiation and chemoemblization cour ses affected the results of TACE.