TACE治疗肝癌后门静脉癌栓形成的危险因素

目的观察TACE后肝癌患者中门静脉癌栓的发生率，探讨门静脉癌栓形成的相关危险因素。方法回顾252例接受TACE治疗的肝癌患者的生化检查、临床和影像学资料，计算门静脉癌栓的发生率，分析门静脉癌栓形成与患者年龄、性别、病灶数目、大体分型、肝硬化、Child-Pugh分级、腹腔积液、甲胎蛋白（AFP）、凝血酶原时间（PT）、谷丙转氨酶（ALT）、谷草转氨酶（AST）、白蛋白（ALB）、总胆红素（TBIL）、直接胆红素（DBIL）、乙肝病毒DNA定量、肝动脉-门静脉分流（APS）等的关系，并以多自变量Logistic回归分析探讨门静脉癌栓形成的相关危险因素。结果TACE后36．51％（92／252）肝癌患者合并门静脉癌栓形成；单因素分析提示门静脉癌栓形成与患者年龄、AFP、AST、PT、病灶数目、大体分型、APS有关，多自变量Logistic回归分析提示年龄、PT、大体分型、APS是肝癌伴门静脉癌栓形成的危险因素。结论年龄较轻、弥漫型肝癌、PT延长、伴APS形成的肝癌患者易于TACE后形成门静脉癌栓，上述各项均为门脉癌栓的独立危险因素。

Risk factors related to formation of portal vein tumor thrombus in hepatocarcinoma patients after TACE

Objective To observe the incidence of portal vein tumor thrombus （PVTT） in hepatocarcinoma patients after TACE, and to investigate the relevant risk factors. Methods TACE was carried out in 252 patients with hepatocarcinoma. The clinical data, imaging findings and biochemical results were retrospectively analyzed to calculate the incidence of PVTT. Single variate analysis was used to analyze the correlation between PVTT and age, sex, the number of tumor, clas- sification, cerrhosis, Child-Pugh, ascites, α-fetoprotein （AFP）, prothrombin time （PT）, alanine aminotransferase （ALT）, aspartate transaminase fAST）, albumin （ALB）, total bilirubin （TBIL）, direct bilirubin （DBIL）, HBV-DNA, arterioportal shunt （APS）, etc. And multivariate Logistic regression method was applied to analyze the risk factors of PVTT. Results The incidence of PVTT in patients with hepatocarcinoma after TACE was 36.51% （92/252）. Age, AFP, AST, PT, the number of tumor, classification and APS performed close relationship with the formation of PVTT. Multivariate Logistic regression indicated that age, PT, classification and APS were risk factors related to the formation of PVTT. Conclusion Yonger patients, diffuse tumors, prolonged PT and APS are risk factors for formation of PVTT in hepatocarcinoma patients after TACE.