原发性肝癌微波消融术后早期复发的影响因素分析

Risk Factors for Early Recurrence after Microwave Ablation in Patients with Primary Hepatocellular Carcinoma

目的探讨原发性肝癌微波消融术后早期复发的影响因素,为预测原发性肝癌微波消融术后复发提供参考依据,以指导术后治疗。方法对2011年1月~2014年6月期间的62例行微波消融术治疗的原发性肝癌患者,采用回顾性分析方法,用Logistic回归进行分析术后患者早期复发的危险因素,用Cox回归分析术后患者无瘤生存期的影响因素。结果术后1年内,共有26例患者复发,复发率为41.9%。Logistic回归分析显示,肿瘤是否有完整包膜和是否邻近大血管对肝癌消融术后复发有影响,差异有统计学意义(P<0.05);Cox回归模型对术后无瘤生存期的多因素分析发现肿瘤数量、肿瘤体积和肿瘤包膜是术后无瘤生存期的独立影响因素,差异有统计学意义(P<0.05)。结论肿瘤位置及肿瘤包膜是肝癌消融术后早期复发的独立危险因素,肿瘤数量、肿瘤体积和肿瘤包膜是微波消融术后无瘤生存期的独立影响因素。

Objective To explore the risk factors for early recurrence of primary hepatocellular carcinoma after microwave ablation, and provide evidence for predicting and preventing tumor recurrence. Methods A retrospective analysis was conducted on the clinical data of 62 patients undergoing microwave ablation for primary HCC therapy during January 2011 to June 2014. Factors possibly influencing early recurrence of HCC after ablation were screened out for identifying the high - risk population and further guiding treatments against re- currence. Results There were 26 cases of recurrence in 1 year after ablation, accounting for a recurrence rate of 41.9%. Logistic regres- sion analysis showed that the location and size of tumors were significantly different between the two groups （ P 〈 O. 05 ）. Multivariate sur- vival analysis performed with Cox regression model showed that the size and number of tumors may affect the tumor - free survival period, and there was a significantly difference （P 〈 0.05）. Conclusion The location and size of tumors are major risk factors for early recur- renee among primary HCC patients with microwave ablation therapy. While the number and size of tumors are major factors that affect the tumor- free survival period.