TACE治疗乙肝相关性肝癌患者预后的影响因素分析

Analysis of factors affecting the prognosis of patients with hepatitis B-associated hepatocellular carcinoma treated by TACE

目的分析肝动脉化疗栓塞术(TACE)治疗乙肝相关性肝癌患者的预后影响因素。方法195例行TACE治疗的乙肝相关性肝癌患者,应用时序检验与对数秩检验进行乙肝相关性肝癌患者的单因素与多因素分析,筛选TACE治疗乙肝相关性肝癌患者的预后影响因素。结果经单因素分析,年龄、有无门静脉转移、Child-Pugh分级、血清胆红素水平、有无腹腔转移是TACE治疗乙肝相关性肝癌患者死亡的影响因素(P<0.05)。多因素分析显示,门静脉转移、腹腔转移、血清胆红素水平高是TACE治疗乙肝相关性肝癌患者死亡的危险因素,Child-Pugh分级低是TACE治疗乙肝相关性肝癌患者死亡的保护因素(P<0.05)。结论Child-Pugh分级低是TACE治疗乙肝相关性肝癌患者死亡的保护因素,血清胆红素水平高、腹腔转移及门静脉转移是TACE治疗乙肝相关性肝癌患者死亡的危险因素,临床治疗时应对上述指标给予重视。

Objective To analyze the factors affecting the prognosis of patients with hepatitis B-associated hepatocellular carcinoma treated by transcatheter arterial chemoembolization(TACE).Methods In 195 patients with hepatitis B-associated hepatocellular carcinoma treated by TACE,single-factor and multi-factor analyses of patients with hepatitis B-associated hepatocellular carcinoma were performed by applying the time-series test and log-rank test to screen the factors affecting the clinical outcomes of patients with hepatitis B-associated hepatocellular carcinoma treated with TACE.Results Univariate analysis showed that age,presence of portal vein metastasis,Child-Pugh grade,serum bilirubin level,and presence of abdominal metastasis were influential factors for death in patients with hepatitis B-associated hepatocellular carcinoma treated by TACE(P<0.05).Multivariate analysis showed that portal vein metastasis,abdominal metastasis,and high serum bilirubin level were risk factors for death in patients with hepatitis B-associated hepatocellular carcinoma treated by TACE,and low Child-Pugh grade was a protective factor for death in patients with hepatitis B-associated hepatocellular carcinoma treated by TACE(P<0.05).Conclusion Low Child-Pugh grade is a protective factor for death in patients with hepatitis B-associated hepatocellular carcinoma treated by TACE,and high serum bilirubin level,abdominal metastasis and portal vein metastasis were risk factors for death in patients with hepatitis B-associated hepatocellular carcinoma treated by TACE,which should be paid attention to in clinical treatment.