肝动脉化疗栓塞术治疗原发性肝细胞癌预后影响因素分析

目的分析肝动脉化疗栓塞术(TACE)治疗原发性肝细胞癌(HCC)的预后影响因素。方法回顾性分析326例接受TACE治疗的HCC患者的资料。采用Kaplan-Meier法计算患者1、2、3年累积生存率,分别以Log-rank检验及Cox比例风险模型进行预后相关单因素及多因素分析。结果患者1、2、3年累积生存率分别为73.90%、40.20%、22.20%,中位生存期21个月。单因素分析显示,甲胎蛋白(AFP)、γ-谷氨酰转肽酶(GGT)、肿瘤最大径、肿瘤数目、肝功能Child-Pugh分级、巴塞罗那临床肝癌(BCLC)分期、门静脉癌栓、动静脉瘘、远处转移为影响HCC患者预后的相关因素(P均0.05)。多因素分析显示,AFP、GGT、肿瘤最大径、肿瘤数目、BCLC分期、动静脉瘘为HCC患者预后的独立影响因素(P均0.05)。结论影响TACE治疗HCC患者预后的独立因素包括AFP、GGT、肿瘤最大径、肿瘤数目、BCLC分期及动静脉瘘。

Prognostic factors of transcatheter arterial chemoembolization for primary hepatocellular carcinoma

Objective To investigate the prognostic factors of transcatheter arterial chemoembolization (TACE) in the treatment of primary hepatocellular carcinoma (HCC). Methods A retrospective analysis was performed on 326 HCC patients treated with TACE. Kaplan-Meier method was used to calculate the 1-year, 2-year and 3-year cumulative survival rates. Log-rank test and Cox proportional hazards model were used to analyze univariate and multivariate prognostic factors, respectively. Results The 1-year, 2-year and 3-year cumulative survival rate of HCC patient was 73.90%, 40.20% and 22.20%, respectively. The median survival time was 21 months. Univariate analysis showed that the alpha-fetoprotein (AFP), gamma-glutamyl transpeptidase (GGT), tumor size, tumor number, Child-Pugh grade, Barcelona clinic liver cancer (BCLC) stage, portal vein thrombosis, arteriovenous fistula and distant metastasis were factors affecting the prognosis of HCC patient (all P<0.05). Multivariate COX regression analysis showed that AFP, GGT, tumor size, tumor number, BCLC stage, arteriovenous fistula were the independent prognostic factors of HCC patients (all P<0.05). Conclusion AFP, GGT, tumor size, tumor number, BCLC stage and arteriovenous fistula are independent prognostic factors of HCC patients treated with TACE.