肝癌经肝动脉化疗栓塞术后复发的临床相关因素研究

目的：研究中晚期肝细胞肝癌经肝动脉化疗栓塞术（TACE）后肝内复发的临床相关因素，为原发性肝癌患者制定合理的治疗方案及为介入治疗预后提供理论依据。方法：收集2006年1月-2011年10月经TACE治疗的454例中晚期肝细胞肝癌，进行单因素分析和Cox比例风险模型分析。结果：治疗有效率有意义的影响因素为：有无乙肝、是否手术、单发与多发、有无腹水、介人次数。预后有意义的影响因素为：谷丙转氨酶、白蛋白、胆红素、有无动静脉瘘、肿瘤类型、门脉癌栓、是否手术、介入次数、治疗间隔。结论：中晚期肝癌经TACE术后复发由多种因素决定，对谷丙转氨酶、白蛋白、胆红素正常，肿瘤相对局限、手术后患者，无门静脉癌栓的患者积极行介入化疗术，可获得较好的疗效。TACE术前评估肝癌术后复发的相关因素有利于治疗方法的选择及判断预后。

The related factors to the recurrence of hepatic carcinoma treated with TACE

Objective：To explore the related factors to recurrence of the intermediate and the advanced stage he- patic carcinoma treated with the transeatheter arterial chemoembolozation （TACE）. Methods：Collecting 454 eases of the intermediate and the advanced stage hepatic carcinoma treated with the transcatheter arterial chemoembolozation in the Tongji Hospital from Junary 2006 to December 2010 ,the dependent variables were recurrent times. To analyze by single factor analysis and Cox model analysis. Results：The single - responses that influenced the efficacy of hepatic carcinoma after TACE were ： type B hepatitis, operation, single or multiple focuses, ascites and frequency of TACE. The multiple factors that most evidently influenced the prognosis of the intermediate and advanced stage hepatic carcinoma were ： GOT, ALB, bilirubin, arteriovenous fistula, the type of tumor, PCTI＇, operation, frequency of TACE, treatment in- terval. Conclusion ：The recurrence of the intermediate and advanced stage hepatic carcinoma was influenced by many factors. The energetic TACE treatment profited better curative effect for the patients with normal AST, albumin and bil- irubin, relatively localized tumor, the patients without tumor embolus in portal vein. Evaluation of recurrence factors before TACE profited the choice of treatments and the judgement of prognosis.