原发性肝癌动脉栓塞联合手术治疗的预后因素分析

Analysis of prognostic factors in primary hepatocellular carcinoma treated with transcatheter arterial embolization and Ⅱ-stage hepatectomy

目的 :研究和分析接受栓塞及手术治疗的原发性肝癌病例的预后因素。方法 :1991年～ 1999年接受栓塞及手术治疗的原发性肝癌 5 3例 ,选择组织学分型、术前肝功能、肿瘤大体形态等 9项指标为研究因素 ,采用Cox回归模型进行多因素分析。结果 :对患者生存期影响显著的因素包括临床分期、组织学分型、术前肝功能、肿瘤大体形态、TACE次数 ,其中TACE次数为正相关 ,其余为负相关。结论 :原发性肝癌的预后因素有多种 ,依治疗方法的不同所起影响也不尽相同。当手术治疗与动脉栓塞治疗联合应用时 ,对预后影响较大的因素包括肝功能情况、肿瘤的临床分期和组织学分型。

Objective:To study the prognostic factors in primary hepatocellular carcinoma (PHC) treated with transcatheter arterial chemoembolization (TACE) and Ⅱ stage hepatectomy.Methods:53 patients with PHC,treated with TACE and Ⅱ stage hepatectomy from 1991 to 1999,were included.9 factors were chosen in this study,using Cox proportional hazard model.Results:The most significant factors were clinical staging,histopathology type,liver function before operation,tumor configuration,number of TACE,the last one was closely related to the prognosis,while others had no relation with it.Conclusion:There are many prognostic factors in PHC with different treatment,ture influence are different.When the patients are treated with TACE and Ⅱ stage hepatectomy,the histopathology type,liver function before operation,tumor configuration are important to the prognosis.And now,some special factors as society and mentality should be paid attention to.