肝癌术后预防性TACE对HCC患者预后的影响

The Influence of Postoperative TACE on the Prognosis in HCC Patients after Liver Resection

目的:探讨肝癌术后行预防性肝动脉化疗栓塞(TACE)对肝细胞癌(HCC)患者生存及预后的影响。方法:回顾性分析80例HCC患者的临床资料,分为两组,其中试验组33例(术后2个月行预防性TACE且未发现病灶),对照组47例(术后病情复发再行TACE)。比较两组患者的生存差异及预后,并对其相关因素进行分析。结果:术后3年,试验组患者生存率(57.58%)远高于对照组(29.79%),差异有统计学意义(字2=6.178,P<0.01)。Pearson相关分析中,门脉癌栓及腹水的有无、凝血酶原时间、肿瘤的大小及是否行预防性TACE是可能影响患者生存率相关因素(P<0.05),而多因素分析则提示肿瘤大小及预防性TACE是显著影响肝癌患者预后独立相关因素(P<0.05)。结论:术后行预防性TACE在延长HCC患者的生存时间,改善预后上有显著优势,可与肿瘤的大小一起作为显著影响HCC患者生存和预后的独立相关因素。

Objective:To investigate the influence of postoperative TAC on the survival time and prognosis in HCC patients after liver resection.Method:A total of 80 HCC patients were retrospectively divided into two groups,33 patients in the experimental group received preventive TACE 2 months after surgery and no lesions were found,and 47 patients in the control group received recurrent TACE after surgery.The survival difference and prognosis of the two groups were compared,and the related factors were analyzed.Result:In the third year after surgery,the survival rate of the experimental group(57.58%)was significantly higher than 29.79%of the control group,and the difference was statistically significant(χ^2=6.178,P<0.01).In the Pearson analysis,the presence or absence of portal vein cancer thrombus and ascites,prothrombin time,tumor size and whether preventive TACE were related factors that might affect the survival rate of patients(P<0.05),while the multivariate analysis suggested that tumor size and preventive TACE were independent factors that significantly affected the prognosis of patients with liver cancer(P<0.05).Conclusion:Prophylactic TACE after surgery has significant advantages in prolonging the survival time and improving the prognosis of HCC patients,and can be used as an independent and relevant factor that significantly affects the survival and prognosis of HCC patients together with the size of tumor.