经皮微波固化治疗小肝癌患者复发和预后的相关因素研究

Related Factors of Recurrence and Prognosis of Small Hepatocellular Carcinoma Treated with Percutaneous Microwave Coagulation Therapy

目的研究经皮微波固化治疗小肝癌患者复发和预后的相关因素。方法回顾性分析50例小肝癌患者的临床资料,患者肿瘤直径≤30 mm。按照复发时间分为早期复发组28例和晚期复发组22例。所有患者经皮微波凝固治疗(PMCT)。对两组患者的特点,包括年龄、性别、病毒标志物、Child-Pugh分级、肿瘤大小、肿瘤细胞分化和血清-α-甲胎蛋白(AFP)的含量进行分析,采用单因素和多因素分析影响局部复发的因素。结果单因素分析显示,肿瘤细胞分化、肿瘤大小及血清AFP浓度影响早期复发率,而肿瘤大小影响晚期复发率。多因素分析显示,肿瘤细胞分化影响早期复发率,肿瘤大小影响晚期复发。PMCT适宜治疗直径≤15 mm的肿瘤。结论经皮微波凝固治疗小肝癌,肿瘤细胞分化和肿瘤大小影响小肝癌患者局部复发。

Objective To study the related factors of recurrence and prognosis of small hepatocellular carcinoma treated with percutaneous microwave coagulation therapy( PMCT). Methods A retrospective analysis of the clinical data of 50 cases of small hepatocellular carcinoma patients were conducted,tumor diameter ≤30 mm. According to the recurrence time,the patients were divided into early recurrence group( n = 28) and late recurrence group( n = 22). All patients received PMCT. Characteristics of patients,including age,sex,viral markers,Child-Pugh grade,tumor size,tumor cell differentiation,and serum-α-alpha-fetoprotein( AFP) levels were analyzed,and factors affecting local recurrence were analyzed by univariate and multivariate analysis.Results Univariate analysis showed that tumor cell differentiation,tumor size,and serum AFP concentration had influence on early recurrence rate,and tumor size had influence on late recurrence rate. Multivariate analysis showed that tumor cell differentiation had influence on early recurrence rate,tumor size had influence on late recurrence. PMCT was appropriate treatment for patients with tumors diameter ≤15 mm. Conclusion Tumor cell differentiation and tumor size are influencing factors of local recurrence of small hepatocellular carcinoma treated with PMCT.