吸烟对经导管动脉内化疗治疗中期男性原发性肝癌患者预后的影响

The influence of smoking history on male intermediate hepatocellular carcinoma treated with TACE

目的探讨烟草因素在经导管动脉内化疗(TACE)治疗BCLC分期标准的B期原发性肝癌(HCC)患者预后中的影响。方法回顾性分析2008年1月至2012年5月解放军总医院介入放射科接受TACE治疗的BCLC分期B期HCC患者293例,按是否有吸烟史分为两组:吸烟组110例,非吸烟组183例,比较其生存情况及预后影响。结果两组患者的1、2、3年生存率分别为77.3%、42.7%、18.2%;81.9%、59.0%、41.5%。吸烟组和非吸烟组患者的中位生存时间分别为23.0个月和29.0个月,差异有统计学意义(P=0.000)。Cox多元回归分析显示:吸烟、Child-Pugh分级、血清AFP浓度及肿瘤大小是BCLC分期B期HCC患者预后的独立危险因素。结论本研究首次发现烟草因素是影响TACE治疗男性BCLC B期的HCC患者预后的独立危险因素。

Objective To investigate the influence of smoking history on male intermediate HCC, Barcelona Clinic Liver Cancer（BCLC） stage B, treated with TACE. Methods A retrospective analysis was conducted on 293 intermediate HCC patients receiving TACE treatment in 301 Hospital Department of Interventional Radiology from January 2008 to May 2012. Survival rates and prognostic significance were compared between the 110 patients（smoking group） and 183 patients（non-smoking group）. The survival rates were calculated using the Kaplan-Meier method. The log-rank method was used for univariate analysis, and the Cox regression model was used for multivariate analysis. Results After patients treated with TACE, the 1, 2 and 3 year survival rates were 77.3%, 42.7%, and 18.2%, respectively,and the median survival time was 23.0 months in the smoking group. The 1, 2 and 3 year survival rates were 81.9%, 59.0%, and 41.5%, respectively, and the median survival time was 29.0 months in the non-smoking group. It has statistically significant（P=0.000） on the median survival time. It was showed that the survival rates（P〈0.05） were related with the following several aspects by univariate analysis：smoking history, Child score, cirrhosis, tumor size, tumor numbers and serum AFP level and the prognosis-related factors were related with the following several aspects by Cox multiple regression analysis： smoking history, Child score, tumor size and serum AFP level. Conclusion It was first found that tobacco is an independent risk factor in male patients with intermediate HCC treated by TACE.