非解剖性肝切除术联合^(125)I 粒子植入治疗对肝细胞癌患者总生存时间的影响

Effect of non-anatomical resection combined with ^(125)I particle implantation on overall survival of patients with hepatocellular carcinoma

目的探讨非解剖性肝切除术(NAR)联合^(125)I粒子植入治疗对肝细胞癌(HCC)患者总生存时间的影响。方法回顾性分析2010年1月至2012年12月在郑州大学人民医院接受NAR治疗的184例HCC患者的临床资料,根据微血管侵犯(MVI)诊断标准将患者分为M_0组(无MVI组)、M_1组(低危组)和M_2组(高危组),比较3组患者总生存时间。结果 184例患者中M_0组53例,M_1组61例,M_2组70例。3组患者术前、术中及术后情况相比,差异无统计学意义(P>0.05)。随访时间为28(6～68)个月。M_0组接受与未接受^(125)I粒子植入治疗患者的中位生存期分别为31、30个月,差异无统计学意义(P>0.05)。M_1组接受与未接受^(125)I粒子植入治疗患者的中位生存期分别为31、27个月,差异有统计学意义(P<0.05)。M_2组接受与未接受^(125)I粒子植入治疗患者的中位生存期分别为30、21个月,差异有统计学意义(P<0.001)。结论 NAR联合^(125)I粒子植入治疗可有效延长伴MVI的HCC患者的总生存时间。

Objective To investigate the effect of non-anatomical resection (NAR) combined with 125I particle implantation on the overall survival of patients with hepatocellular carcinoma (HCC). Methods The clinical data of 184 patients with HCC who underwent NAR in People’s Hospital of Zhengzhou University from January of 2010 to December of 2012 were retrospectively analyzed. According to the diagnostic criteria of microvascular invasion (MVI),patients were classified into M0 group (no MVI group),M1 group (low-risk group),and M2 group (high-risk group). Overall survival of the 3 groups was compared. Results Of the 184 patients,53 were in M0 group,61 in M1 group,and 70 in M2 group. There were no significant differences in preoperative,intraoperative and postoperative conditions among 3 groups ( P >0.05). In M0 group,the median survival time of patients receiving and not receiving 125I particle implantation was respectively 31 and 30 months,and the difference was not statistically significant ( P >0.05). In M1 group,the median survival time of patients receiving and not receiving 125I particle implantation was respectively 31 and 27 months,and the difference was statistically significant ( P <0.05). In M2 group,the median survival of patients receiving and not receiving 125I particle implantation was respectively 30 and 21 months,and the difference was statistically significant ( P <0.001). Conclusion NAR combined with 125 I particle implantation can effectively prolong the overall survival of patients with HCC with MVI.