原发性肝癌射频治疗的预后影响因素分析

Analysis of prognostic factors affecting radiofrequency ablation for primary hepatic carcinoma

目的探讨原发性肝癌射频消融(RFA)治疗的预后影响因素,为原发性肝癌患者选择个体化治疗方案及估计预后提供参考。方法回顾性分析134例行RFA治疗的原发性肝癌患者,以生存时间和生存结局作为因变量,分析11项可能影响预后的相关因素。单因素分析采用Kaplan-Meier模型及Log-rank检验,多因素分析采用Cox比例风险模型。结果患者治疗后3个月起随访观察生存情况,随访至2012年6月,随访率达95.5%。单因素分析结果显示,肝功能Child-Pugh分级、肿瘤类型、门静脉高压、AFP值、治疗目的方案和术前有无实施肝动脉化学栓塞(TACE)有统计学意义。Cox模型多因素分析结果显示,与生存率相关的因素有Child-Pugh分级、门静脉高压、治疗目的方案和术前实施TACE。结论影响原发性肝癌RFA治疗预后的因素为肝功能Child-Pugh分级、门脉高压程度、治疗目的方案和术前实施TACE。以上结果有助于指导原发性肝癌患者的RFA治疗。

Objective To investigate the prognostic factors affecting outcome in radiofrequency ablation for primary hepatic carcinoma,and to select the individualized treatment plan for patients and estimate prognosis.Methods Retrospectively analyzed 134 patients with primary hepatic carcinoma treated by RFA,with the survival time and survival outcomes as the dependent variable,to analyze 11 possible prognostic factors affecting outcome.Kaplan-Meier model and Log-rank test were used in univariate analysis and COX proportional hazards model was used in multivariate analysis.Results Three months after treatment,follow up survey for patients was made to June 2012,with the rate of 95.5%.In results of univariate analysis,6 factors were statistically significant：Child-Pugh grade,tumor type,portal hypertension,AFP value,treatment purpose and pre-optional TACE treatment.Results of COX model multivariate analysis revealed that 4 factors were associated with survival rate：Child-Pugh grade,portal hypertension,treatment purpose and pre-optional TACE treatment.Conclusions There are 4 factors affecting the prognosis of patients with primary hepatic carcinoma：Child-Pugh grade,portal hypertension,treatment purpose and pre-optional TACE treatment,which are helpful for guiding RFA treatment for patients with primary hepatic carcinoma.