老年原发性肝癌微波消融术后复发危险因素的多元COX回归分析

Multivariate COX regression analysis of recurrence after radiofrequency ablation of primary liver cancer in the elderly

目的按探讨老年原发性肝癌微波消融术后复发多元COX回归模型。方法去选择我院于2018年9月至2021年9月收治的原发性肝癌患者183例,均行微波消融术治疗。所有患者均随访至2023年9月,定期门诊、住院随访,于微波消融术后前3个月内,每月进行1次随访,之后以每3个月进行1次随访,随访终点为患者出现肿瘤复发。以完全消融术后肝内重复出现肝癌或者远处发生转移为复发。采用多元COX回归模型分析影响老年原发性肝癌微波消融术后复发危险因素。结果随访末,微波消融术治疗原发性肝癌患者183例中,复发患者39例,复发率为21.31%。单因素COX回归分析,不同性别、不同年龄、家族史、合并肝硬化、Chlid-Pugh分级、AST、ALT、HBVDNA阳性、腹水、脾大和消融次数复发率比较无明显差异(P>0.05);肿瘤直径>3cm复发率高于肿瘤直径≤3cm,AFP>400ng/ml复发率高于AFP≤400ng/ml(P<0.05)。经多元C0X回归模型分析显示,肿瘤直径>3cm和血清AFP>400ng/ml为影响微波消融术后复发危险因素。结论老年原发性肝癌微波消融术后复发率较高,而肿瘤直径和血清AFP为其危险因素.

Objective To explore the multiple COX regression model of recurrence of primary liver cancer in the elderly after radiofrequency ablation.Methods The 183 patients with primary liver cancer in our hospital from March 2018 to June 2021 were se-lected.All patients were followed up to March 2023.They were followed up in outpatient and inpatient regularly.They were followed up once a month in the first three months after radiofrequency ablation,and then once every three months.The end point of follow-up was tumor recurrence.The recurrence was recurrence of recurrent liver cancer or distant metastasis after complete ablation.Multivariate COX regression model was used to analyze the risk factors of recurrence after RFCA.Results At the end of follow-up,among 183 pa-tients with primary liver cancer treated by radiofrequency ablation,39 had relapse,the recurrence rate was 21.31%.Single factor COX regression analysis showed that there was no significant difference in the recurrence rate of different gender,age,family history,cirrhosis,chlid Pugh classification,AST,ALT,HBV DNA positive,ascites,splenomegaly and ablation frequency(P>0.05);the recurrence rate of tumor diameter>3cm was higher than that of tumor diameter≤3cm,and the recurrence rate of AFP>400ng/ml was higher than that of AFP≤400ng/ml(P<0.05).Multiple Cox regression model analysis showed that tumor diameter>3cm and serum AFP>40Ong/ml were the risk factors of recurrence after RFA.Conclusion the recurrence rate of elderly primary liver cancer after radiofrequency ablation is high,and the tumor diameter and serum AFP are the risk factors.