摘要
目的探讨影响肝转移瘤介入治疗效果因素,为临床治疗肝转移瘤提供理论依据。方法随访观察1 009例肝转移瘤介入治疗患者,共计行2724次肝动脉灌注化疗栓塞术,对可能影响肝转移瘤介入治疗效果的所有因素采用Cox多因素回归分析。结果 1 009例肝转移瘤介入治疗后中位生存期为13.5个月,0.5、1、2、3、5年累积生存率分别为86.4%、66.8%、35.6%、16.9%、7.3%,总有效率50.4%,所有患者无严重介入治疗并发症。Cox多因素回归分析显示:经济因素、原发肿瘤是否切除、原发肿瘤来源、原发肿瘤病理类型及分化程度、肝内转移≤3个或是>3个、门静脉瘤栓、肝肾功能状态、介入治疗前是否有其他部位转移、肝转移瘤血供状况、应用超选择微导管技术、侧支循环、介入治疗前后是否行辅助化疗或其他治疗等因素是介入治疗肝转移瘤效果的危险因素(P<0.05);肝转移瘤血供状况、原发肿瘤病理类型、原发肿瘤是否切除、门静脉是否有瘤栓、肝内转移瘤转移数目≤3个、介入治疗前是否有其他部位转移、介入治疗前后是否行辅助化疗或其他治疗为影响介入治疗肝转移瘤效果的主要因素(P<0.05),而与性别、年龄及肝转移瘤发生部位无明显相关(P>0.05)。结论对于肝转移瘤病灶≤3个、原发病灶切除且病理类型分化程度越高、血供越丰富且无侧支循环、介入治疗前无其他部位转移、介入前后行辅助化疗或其他治疗、多次行介入治疗且肝肾功能正常的肝转移瘤患者介入治疗效果更佳、生存期更长。
Objective To analyze the influential factors on clinical effects of interventional therapy in liver metastases.Methods Observation was made on 1 009 patients with liver metastases in our hospital,all received 2 724 times of transcatheter hepatic artery interventional therapy,and the multivariate Cox regression analysis was applied for analyzing the factors.Results The median survival of 1 009 patients was 13.5 months,the cumulative survival rate of 0.5,1,2,3,5 years was 86.4%,66.8%,35.6%,16.9%and 7.3%,CR ＋ PR was 50.4%.There were no serious complications.The multivariate Cox regression analysis indicated the factors of economic factors,whether the primary tumor resection,primary neoplasm,primary tumor pathologic type and differentiation degree,whether the number of liver metastases above 3,tumor embolus of portal vein,liver and kidney function,other organ metastases,the blood supply of liver metastases,micro tube technology,collateral circulation,the auxiliary treatment obviously associated with curative effects of interventional therapy for liver metastases（P〈0.05）.The gender,age and location of the liver metastases did not associated with the curative effects of interventional therapy（P〉0.05）.Conclusion The patients with the number of liver metastases≤3,primary lesion resection,pathological type differentiation higher degree,the rich blood supply and no collateral circulation,no other organ metastases,adjuvant chemotherapy,multiple interventional therapy and normal liver and kidney function have better therapeutic effect and longer survival period.
出处
《河北医科大学学报》
CAS
2015年第3期304-308,共5页
Journal of Hebei Medical University
基金
河北省医学科学研究重点课题(20110139)
河北省医学科学研究重点课题(20120356)
关键词
肝肿瘤
肿瘤转移
因素分析
统计学
liver neoplasms
neoplasm metastasis
factor analysis
statistical
