肝癌术后肝动脉化疗栓塞治疗患者肿瘤复发的影响因素分析

Analysis of factors influencing the recurrence of hepatocellular carcinoma after transcatheter hepatic arterial chemoembolization

目的探讨影响肝癌术后经导管肝动脉化疗栓塞治疗(TACE)患者肿瘤复发的危险因素。方法选择并收集200例肝癌患者的年龄、性别等一般人口学特征和临床特征资料并对患者进行随访追踪,采用Logistic逐步回归分析法分析肿瘤复发的影响因素。结果在200例患者中130例有肿瘤复发,占65.0%。Logistic逐步回归分析结果显示,血管癌栓(OR=3.796;95%CI:1.871~7.702)、侵透肝被膜(OR=3.340;95%CI:1.067~10.451)、肝硬化(OR=2.790;95%CI:1.771~4.396)、包膜完整性(OR=2.048;95%CI:1.273~3.298)和最大癌结节直径(OR=1.739;95%CI:1.014~2.980)是肝癌术后TACE治疗患者肿瘤复发的危险因素。结论肝癌术后TACE治疗患者的肿瘤复发率较高,术前有无血管癌栓、侵透肝被膜和肝硬化,包膜是否完整,以及肿瘤的直径等均会影响肿瘤复发,临床需要加强患者术后复诊和康复治疗。

Objective To explore the risk factors of postoperative recurrence of patients with hepatocellular carcinoma after transcatheter hepatic arterial chemoembolization（TACE）. Method A total of 200 patients with liver cancer were included in this study. The demographic and clinical characteristics of the patients were collected and the patients were followed up. Logistic stepwise regression was used to analyze the risk factors. Result Of the 200 subjects, 130 patients had tumor recurrence, accounting for 65.0%. Logistic regression analysis showed that the vascular tumor thrombus（OR=3.796; 95%CI： 1.871～7.702）, liver capsule invasion（OR=3.340; 95%CI： 1.067～10.451）, cirrhosis（OR=2.790; 95%CI：1.771～4.396）, capsule integrity（OR=2.048; 95% CI： 1.273～3.298） and maximal nodule diameter（OR=1.739; 95% CI：1.014～2.980）, and were risk factors in patients with recurrence after postoperative TACE. Conclusion The recurrence rate of hepatocellular carcinoma after TACE is relatively high, the presence of vascular tumor thrombus, liver capsule invasion, cirrhosis, capsule integrity and the diameter of tumor will influence the recurrence rate, so the postoperative visits and rehabilitation treatment should be addressed.