肝动脉化疗栓塞治疗原发性肝癌的预后因素分析

目的：探讨影响肝动脉化疗栓塞治疗原发性肝癌预后的相关因素，为原发性肝癌患者选择个体化治疗方案及估计预后提供参考。方法：回顾性分析2003年6月-2012年6月石河子大学医学院第一附属医院实施肝动脉化疗栓塞的153例患者的临床资料及随访数据，生存分析采用生命表法，相关因素分析行 Log -rank 检验，多因素分析采用 Cox 模型，筛选出影响预后的因素。结果：随访至2013年6月30日153例患者失访15例（9.8%），原发性肝癌患者经肝动脉化疗栓塞后1、3、5年生存率分别为55.92%、31.02%、21.18%。单因素分析结果显示肝功能分级、甲胎蛋白（AFP）、肿瘤大小、肿瘤数目、门脉癌栓及治疗次数是影响预后的因素；Cox 风险回归分析显示肝功能分级、肿瘤数目、门脉癌栓及治疗次数是影响预后的独立因素（P <0.05）。结论：肝功能分级、肿瘤数目、门脉癌栓为影响原发性肝癌介入治疗预后的独立危险因素，而治疗次数是影响预后的保护性因素。

Prognostic factors of TACE treatment in patients with primary hepatic carcinoma

Objective:To study the prognostic factors of transhepatic arterial chemotherapy and embolization(TA-CE)in treating primary hepatocarcinoma(HCC). Methods:The clinical and follow - up data of 153 cases with TACE were analyzed retrospectively. Survival analysis was used and the life table method,related factor was used for Log -rank test,Cox model was used for multiple - factor analysis. Results:Follow - up until June 30,2013,15 cases of 153 patients were lost to follow - up(9. 8% ),the 1 - year,3 - year,5 - year survival rates in 138 cases were 55. 92% , 31. 02% and 21. 18% respectively. Single factor analysis showed that influencing factors of prognosis were Child -Pugh,alpha fetal protein(AFP),tumor size,the number of tumor,portal vein tumor thrombus(PVTT)and the num-ber of treatment. Cox regression analysis showed that independent factors of prognosis were Child - Pugh,the number of tumor,the number of treatment,portal vein tumor thrombus(PVTT). Conclusion:Independent risk factors of TA-CE prognosis were Child - Pugh,the number of tumor,portal vein tumor thrombus(PVTT),protective factor of TACE prognosis was the number of treatment.