摘要
背景与目的:肝癌是我国的高发恶性肿瘤,预后较差。本研究通过分析我院维吾尔族原发性肝癌病例,旨在发现影响其长期生存的预后因素,并分析不同治疗模式的疗效差异。方法:回顾性分析246例维吾尔族原发性肝癌患者的临床资料,应用Kaplan-Meier方法计算生存率,对可能影响患者预后的因素采用Log-rank检验进行单因素分析,并用COX回归模型进行多因素分析,以筛选出独立的预后因素。结果:246例患者总的中位生存期(overall survival,OS)为10.7个月。1、2、3、5年生存率分别为41.97%、22.13%、14.87%和8.92%。多因素分析显示,患者年龄(P=0.003)、肿瘤分期(P=0.000)、门脉癌栓(P=0.000)、Child-Pugh分级(P=0.000)及血清LDH水平(P=0.000)是影响患者生存的独立因素。应用手术、肝动脉化疗栓塞术(transcatheter hepatic arterial chemoembolization,TACE)、放化疗、射频消融(radiofrequencyablation,RFA)等治疗手段的患者中位OS为19.2个月,对症支持治疗患者中位OS仅为9.1个月。综合治疗疗效优于单一治疗,其中以手术为主的综合治疗中位OS达到64.9个月。结论:患者年龄、肿瘤分期、门脉癌栓、Child-Pugh分级及血清LDH水平是影响维吾尔族原发性肝癌患者预后的重要独立因素。而采用手术切除、TACE、放化疗、RFA等治疗的总体疗效显著高于支持对症治疗。综合治疗的疗效优于单一治疗,而以手术切除为主的综合治疗是较理想的治疗手段。
Background and purpose： Primary hepatic carcinoma is a high incidence malignant tumor in China, and the prognosis is poor. The study aimed to investigate the prognostic influencing factors and the effects of different treatments by analyzing Uyghur patients with primary hepatic carcinoma treated in our hospital. Methods： We retrospectively analyzed the clinical data of 246 Uyghur patients with primary hepatic carcinoma. Kaplan-Meier method was used to calculate survival rate, univariate analysis by log-rank test was used to determine the prognostic influencing factors, and multivariate analysis by Cox proportional hazard model was used to determine the independent factors of prognosis. Results： The median survival time of the 246 patients was 10.7 months. The 1-, 2-, 3-, 4-, and 5-year survival rates were 41.97%, 22.13%, 14.87% and 8.92% respectively. The multivariate analysis indicated that age （P=0.003）, tumor staging （P=0.000）, portal cancerous thrombus （P=0.000）, Child-Pugh grading （P=0.000） and levels of serum LDH （P=0.000） were independent prognostic factors influencing survival. The median survival time of patients treated by surgery, TACE, chemoradiation or RFA was 19.2 months, which was only 9.1 months for the supportive therapy group. The efficacy of combined therapeutic group was better than that of single treatment group. Conclusion： The independent prognosis factors included age, neoplasm staging, portal vein cancerous thrombus, Child-Pugh grading and levels of serum LDH in Uyghur patients with primary hepatic carcinoma. The therapeutic efficacy of surgery,TACE, chemoradiation and RFA are significantly better than that of support therapy, combined therapy is better than that of single therapy.
出处
《中国癌症杂志》
CAS
CSCD
北大核心
2013年第5期362-369,共8页
China Oncology
基金
乌鲁木齐市科学技术计划项目(No:H111313001,Y111310002)
关键词
维吾尔族
原发性肝癌
预后因素
疗效
Uyghur
Primary hepatic carcinoma
Prognostic factors
Therapeutic efficacy
