肝动脉化疗栓塞术治疗原发性肝细胞癌预后影响因素分析

Prognostic factors of transcatheter arterial chemoembolization for primary hepatocellular carcinoma

目的分析肝动脉化疗栓塞术(TACE)治疗原发性肝细胞癌(HCC)的预后影响因素。方法回顾性分析326例接受TACE治疗的HCC患者的资料。采用Kaplan-Meier法计算患者1、2、3年累积生存率,分别以Log-rank检验及Cox比例风险模型进行预后相关单因素及多因素分析。结果患者1、2、3年累积生存率分别为73.90%、40.20%、22.20%,中位生存期21个月。单因素分析显示,甲胎蛋白(AFP)、γ-谷氨酰转肽酶(GGT)、肿瘤最大径、肿瘤数目、肝功能Child-Pugh分级、巴塞罗那临床肝癌(BCLC)分期、门静脉癌栓、动静脉瘘、远处转移为影响HCC患者预后的相关因素(P均<0.05)。多因素分析显示,AFP、GGT、肿瘤最大径、肿瘤数目、BCLC分期、动静脉瘘为HCC患者预后的独立影响因素(P均<0.05)。结论影响TACE治疗HCC患者预后的独立因素包括AFP、GGT、肿瘤最大径、肿瘤数目、BCLC分期及动静脉瘘。

Objective To investigate the prognostic factors of transcatheter arterial chemoembolization （TACE） in the treatment of primary hepatocellular carcinoma （HCC）. Methods A retrospective analysis was performed on 326 HCC patients treated with TACE. Kaplan-Meier method was used to calculate the 1-year, 2-year and 3-year cumulative survival rates. Log-rank test and Cox proportional hazards model were used to analyze univariate and multivariate prognostic factors, respectively. Results The 1-year, 2-year and 3-year cumulative survival rate of HCC patient was 73.90%, 40.20% and 22.20%, respectively. The median survival time was 21 months. Univariate analysis showed that the alpha-fetoprotein （AFP）, gamma-glutamyl transpeptidase （GGT）, tumor size, tumor number, Child-Pugh grade, Barcelona clinic liver cancer （BCLC） stage, portal vein thrombosis, arteriovenous fistula and distant metastasis were factors affecting the prognosis of HCC patient （all P〈0.05）. Multivariate COX regression analysis showed that AFP, GGT, tumor size, tumor number, BCLC stage, arteriovenous fistula were the independent prognostic factors of HCC patients （all P〈0.05）. Conclusion AFP, GGT, tumor size, tumor number, BCLC stage and arteriovenous fistula are independent prognostic factors of HCC patients treated with TACE.