瘤内无水酒精注射治疗肝癌切除术后复发的疗效及预后因素分析

目的：研究经皮瘤内酒精注射（pereutaneous ethanol injection，PEI）治疗原发性肝癌术后复发病灶的疗效，分析影响预后的因素。方法：原发性肝癌术后复发患者行PEI治疗，部分患者合用射频毁损治疗（radiofrequency ablation，RFA）、肝动脉化疗栓塞治疗（transcatheter arterial chemoembolization，TACE）。采用寿命表法分析患者复发后的生存期，并分析影响患者生存期的因素。结果：58例术后复发患者治疗后1、3、5年生存率分别为96.6％、59．2％、29．3％，中位生存期为42．5个月。单因素分析显示Child-Pugh分级B级为疗效差的影响因素，合用RFA有助于提高疗效；多因素分析显示Child-Pugh分级为独立的预后因素。结论：酒精注射治疗复发性肝癌可取得较好疗效。

Percutaneous Ethanol Injection for Postoperative Reccurent Tumor of Hepatocellular Carcinoma

Objective:To evaluate the survival and analyze prognostic factors of postoperative reccurent tumor of hepatocellular carcinoma (HCC) treated by percutaneous ethanol injection (PEI). Methods:PEI (or combined with radiofrequency ablation (RFA) or transcatheter arterial chemoembolization (TACE) was performed in 58 patients who were diagnosed as reccurent lesions. Life-table method was used for survival and prognostic factors were analysed. Results: The 1-,3- and 5-year survival rates were 96. 6%,59.2%,29.3%, with a median survial of 42.5 months. Univariate analysis indicated that Child-Pugh grade B was an important factor indicating a poor prognosis,the combination with RFA indicated a better prognosis. However,multivariate analysis showed that Child-Pugh grade was independent factor of prognosis. Conclusion: PEI is effective in treating the postoperative reccurent tumor of hepatocellular carcinoma,especially in the patients with good liver function reserve.