摘要
目的研究肝癌切除术联合术后经动脉化疗栓塞(transcatheter arterial chemoembolization,TACE)对原发性肝癌(以下简称肝癌)合并门静脉癌栓患者的治疗效果,并分析影响预后的相关因素。方法回顾性分析2008年4月至2011年4月本院收治的123例肝癌合并门静脉癌栓患者的临床资料,根据治疗方法不同将入选患者分为联合组(55例)及对照组(68例)。联合组患者行肝癌切除术联合术后TACE,对照组患者仅行肝癌切除术。对比两组患者术后3个月的疗效及术后生存率,对患者预后的影响因素进行单因素及多元Logistic回归分析。结果联合组患者术后3个月肿瘤总控制率及术后第1、2、3年生存率均显著高于对照组(P<0.05)。单因素分析显示,肝静脉癌栓、癌栓类型、肿瘤个数、肿瘤直径及术后TACE是影响预后的主要因素(P<0.05)。多元Logistic回归分析显示,肝静脉癌栓、癌栓类型及术后TACE是影响预后的独立因素(P<0.05)。结论对于肝癌合并门静脉癌栓患者,在条件允许的前提下应尽早实施肝癌切除术及术后TACE,可有效延长患者的生存期。患者预后受肝静脉癌栓及癌栓类型的影响。
Objective To explore the clinical effect of postoperative TACE combined with hepatic carcinectomy in the treatment of primary carcinoma of the liver with portal vein tumor thrombus and to analyze its prognostic factors. Method From April 2008 to April 2011, 123 primary carcinoma of the liver with portal vein tumor thrombus patients admitted in our hospital were divided into combination group and control group according to the different cancer therapeutics. Patients in combination group were treated with hepatic carcinectomy with postoperative TACE while patients in control group accepted hepatic carcinectomy only. Compared the short-term e？cacy for 3 months and the postoperative survival rate of the two groups. Analyzed the prognostic factors by single factor analysis and multiple Logistic regression analysis. Result The total control rate of 3 months after operation, the 1-, 2- and 3-year survival rates of combination group were higher than control group （P 〈 0.05）. Single factor analysis showed that hepatic vein tumor thrombus, tumor thrombus type, number of tumor, diameters of tumor and postoperative TACE were prognostic factors （P 〈 0.05）. And the multiple Logistic regression analysis showed that hepatic vein tumor thrombus, tumor thrombus type and postoperative TACE were independent prognostic factors （P 〈 0.05）. Conclusion In the treatement of primary carcinoma of the liver with portal vein tumor thrombus, hepatic carcinectomy combined with postoperative TACE should be applied as soon as possible to prolonging survival period of patients. Hepatic vein tumor thrombus, tumor thrombus type are the independent prognostic factors of hepatocellular carcinoma with portal vein tumor thrombus.
出处
《中国医学前沿杂志（电子版）》
2016年第6期160-164,共5页
Chinese Journal of the Frontiers of Medical Science(Electronic Version)
关键词
原发性肝癌
门静脉癌栓
经动脉化疗栓塞
肝癌切除术
Primary carcinoma of the liver
Portal vein tumor thrombus
Transcatheter arterial chemoemb-olization
Hepatic carcinectomy
