肝癌TACE疗效的影响因素分析

Analysis of the influence factors of TACE cruative effect of hepatocellular carcinoma

目的:探讨肝细胞癌(hepatocellular carcinoma,HCC)TACE治疗疗效的影响因素。方法:回顾性分析89例经TACE治疗的HCC患者的临床及影像资料,比较治疗前后CT影像及临床指标的变化,分析影响肿瘤变化的主要相关因素。结果:治疗前肿瘤体积与肝脏体积之比(TTLVR)(P=0.042,rs=-0.216)、有无门静脉侵犯(P<0.001,Z/χ2=-4.680)、AFP(P=0.004,rs=-0.036)为影响肿瘤大小变化率的负相关因素;碘油沉积率(LDR)(P<0.001,rs=0.728)为正相关因素。LDR为影响TACE治疗效果的主要因素(P<0.001)。治疗前TTLVR(P<0.001,rs=-0.385)、有无门静脉侵犯(P<0.001,Z/χ2=-4.289)及有无腹水(P=0.045,rs=-2.001)是影响LDR的负相关因素;年龄(P=0.016,rs=0.254)是正相关因素。结论:治疗前有无门静脉侵犯及对AFP、TTLVR、LDR的测定有助于肝癌TACE疗效的判定;年龄、有无门静脉侵犯、肿瘤大小、腹水有助于LDR的判定。

Objective：To analyze the influence factors of the cruative effect of transcatheter arterial chemoembolization （TACE） of hepatocellular carcinoma. Methods： 89 cases of HCC clinical and imaging data were analyzed retrospectively,all cases were treated by TACE . The changes of CT imaging and clinical indicators pro- and post-TACE were compared, the major influence factors of tumor change were analyzed. Results： Before treatment, TTLVR （P = 0. 042, rs = - 0.216）, portal vein invasion （P〈 0. 001 ,Z/χ^2= -4. 680） and AFP （P= 0. 004, rs=-0. 219） were negatively related factors of tumor size, lipiodol deposition rate（LDR） （P〈0. 001, rs =0. 728） with a positive correlation. The major prognostic factor was the degree of LDR. Before treatment tumor to liver volume ratio （TTLVR） （P〈0. 001, rs= 0. 385）, portal vein thrombosis （P〈0. 001, Z/χ^2 = - 4. 289） and ascites （P=0. 045 ,rs =-2. 001） were negatively related factors influencing lipiodol deposition,age （P=0. 016 ,rs =0. 254） with a positive correlation. Conclusions：Portal vein thrombosis before treatment and AFP, TTLVR,lipiodol deposition rate can help to determine the efficacy of TACE. Age,portal vein thrombosis,tumor size,ascites can help determine lipiodol deposition.