西藏地区藏族肝癌的生存情况及其影响因素

The Clinical characteristics and survival analysis of primary hepatocellular carcinoma in Tibetan Tibetan Plateau

目的了解世居藏族原发性肝癌(primary liver cancer,PLC,以下简称PLC)的生存情况及其影响因素。方法选取2012年9月~2016年9月期间,在我院肿瘤科确诊为PLC患者192例,通过电话跟踪随访,并对其基本情况及随访信息用IBM SPSS Stastics 19软件进行分析。结果 192例PLC以男性为主;首次入院TNM分期以Ⅲ期、Ⅳ期(进展期)为177例(92.19%);4年死亡160例(83.33%),总体中位总生存期7.93月,其中男性8.28月,女6.97月;单因素分析示肿瘤的首诊KPS评分70分及以下、血清Hbs Ag阳性、AFP阳性病史、未行综合治疗是决定预后的危险因素,COX多因素分析示对模型总体检验有显著意义(P<0.001);未行TACE治疗和专科治疗是影响预后的独立危险因素。结论高原世居藏族PLC病例就诊时分期普遍较晚,总体生存率较低。未行经导管动脉化学栓塞(transcatheter arterial chemoembolization,TACE,下文简称TACE)治疗和未专科治疗是影响高原藏族原发性肝癌预后的独立危险因素。

Objective： To investigate the survival situation and influencing factors on primary liver cancer （PLC,hereinafter referred to as PLC） in the crowd of plateau indigenous Tibetan. Methods A retrospective analysis was performed for the clinical data of 192 patients who were admitted to the People＇ s hospital of Tibet Autonomous Region and diagnosed with PLC for the first time form September 2012 - September 2016 with the same period, which cases were followed up by telephone until to September of 2016, and the basic status and follow- up information are analyzed by IBM SPSS Statistics 19 software . Results Among the 192 cases of PLC are mainly male patients, the TNM staging phase Ill , IV （advanced） were most at the first diagnose , both accounted for 92.19% （177 cases） of all enrolled patients, TNM staging of women was significantly later than men （P = 0.001）. Overall median overall suvcival for 6.63 months, and the overall survival rate of 0.5, 1,2,3,4 years for 55.19%, 21.89%,5.50%, 2.75% independently.The survival rate of 1-year was affected not by some factors such as the sex, age, occupation, history of liver disease, the altitude of indigenous and AFP at the first diagnosis, but by the TNM staging at the first diagnosis , the KPS score at the first diagnosis and whether TEA treatment or not （P 〈0.05）, Univariate analysis showed that the first diagnosis of tumor KPS score 70 points and below, serum HbsAg positive history, pre-treatment AFP positive, without TACE treatment, no comprehensive treatment, no specialist treatment is to determine the prognosis risk factors, COX multivariate analysis The overall test showed significant （P 〈0.001）, without TACE treatment and specialist treatment is independent prognostic risk factors. Conclusions The study shows that the plateau indigenous Tibetan who given with PLC are generally later about the staging.The overall survival rate was significantly lower than that at home and abroad. Whether TACE and specialist treatment or not is an independent risk factor for the prognosis about the crowd ofplatean indigenous Tibetan.