肝癌TACE术后生存期小于1年及大于3年的相关影响因素分析

Analysis of related influencing factors of survival time of less than one year and longer than 3 years in liver cancer after TACE

目的探讨肝癌患者肝动脉化疗栓塞术(TACE)后小于1年及大于3年生存期的影响因素。方法收集采用TACE治疗肝癌患者的临床资料,按生存期分组,对各变量进行单因素方差分析,采用多因素Cox逐步回归分析影响生存期的因素。结果单因素方差分析与生存期有关的因素有:年龄、门静脉癌栓、肿瘤缩小率、AFP状态、癌灶类型和分布、治疗次数、肿瘤数目、癌灶占据率、碘油沉积率、Child-Pugh分级、BCLC临床分期、有无假包膜;多因素分析与生存期显著相关的变量为:Child-Pugh分级、碘油沉积率、门静脉癌栓、BCLC临床分期。结论除了Child-Pugh分级、碘油沉积率、门静脉癌栓、BCLC临床分期为中位生存期独立危险性因素外,AFP变化、肿瘤数目、年龄为生存期小于1年的相对危险性因素;肿瘤缩小率、癌灶占据率为大于36个月的生存期相对危险性因素。

Objective To investigate the influencing factors of survival time of less than 1 year and longer than 3 years in liver cancer after transcatheter arterial chemoembolization（TACE）. Methods Clinical data of patients with liver cancer who were treated by TACE were collected and analyzed by univariate analysis of variance（ANOVA） according to the grouping by survival time. Multivariate Cox stepwise regression analysis was used to analyze the factors influencing the survival time. Results One-way analysis of variance（ANOVA） which was associated with survival time was age, portal vein tumor thrombus, tumor shrinkage rate, AFP state, type and distribution of foci, number of treatment, amount of tumor, foci occupancy, lipiodol deposition rate, Child-Pugh grade, BCLC clinical staging, and pseudocapsule; multivariate analysis which was significantly associated with survival time was Child-Pugh grade, lipiodol deposition rate, portal vein tumor thrombus, and BCLC clinical staging. Conclusion In addition to Child-Pugh grade, lipiodol deposition rate,portal vein tumor thrombus, BCLC clinical staging as the median survival time independent risk factors, AFP changes,number of tumors, and age are relative risk factors of survival for less than 1 year; tumor shrinkage rate, occupying rate of cancer are relative risk factors of survival for over 36 months.