摘要
目的探讨影响经导管肝动脉化疗栓塞(TACE)治疗乙肝相关性肝细胞癌患者预后的相关因素。方法随机选取2013年1月至2015年12月收治的行TACE治疗的乙型肝炎相关性肝细胞癌患者120例作为研究对象,观察入选患者1年的生存情况,随访观察2016年12月截止。对影响TACE治疗的乙型肝炎相关性肝细胞癌患者预后的相关因素进行分析。结果单因素分析结果显示,抗病毒治疗、低门冬氨酸氨基转移酶(AST)水平(<80 U/L)、低血清胆红素水平(<34.2μmol/L)、Child-Pugh分级较低、无腹腔转移、无胸腔转移、无门静脉转移、年龄较低、介入治疗次数较多(3～4次)的患者病死率较低(P<0.05或P<0.01)。在进行TACE治疗的同时联用抗病毒治疗与不联用抗病毒治疗方案的Child-Pugh A级患者生存情况存在明显差异(P=0.003)。多因素分析结果显示,TACE治疗次数(P=0.000)、抗病毒治疗(P=0.000)、胆红素水平(P=0.017)、腹腔转移(P=0.009)、门静脉转移(P=0.004)是TACE治疗的乙型肝炎相关性肝癌患者预后的相关影响因素。结论影响TACE治疗的乙型肝炎相关性肝细胞癌患者预后的独立危险因素可能包括较高胆红素水平、腹腔转移以及门静脉转移,而其保护性因素则可能包括较多的TACE介入治疗的次数以及抗病毒治疗。
Objective To explore the influence factors on the prognosis of patients with hepatitis B-related hepatocellular carcinoma(HCC) treated with transcatheter arterial chemoembolization(TACE).Method A total of 120 patients with hepatitis B-related HCC,who underwent TACE from January 2013 to December 2015,were randomly selected as the study subjects and were followed up until December 2016 to observe one-year survival after treatment.The related prognostic factors of patients were screened and analyzed.Results The univariate analysis showed that antiviral therapy,low aspartate aminotransferase(AST) level(<80 U/L),low serum bilirubin level(<34.2 μmol/L),low Child-Pugh classification,no intra-abdominal metastasis,no pleural metastasis,no portal vein metastasis,younger and more times of interventional treatments were the factors influencing the prognosis of patients(P<0.05 or P<0.01).There was a significant difference in survival condition between patients treated with TACE plus antiviral therapy and patients treated with TACE without antiviral therapy in Child-Pugh A patients(P=0.003).Multivariate analysis showed that the frequency of TACE treatment(P=0.000),antiviral treatment(P=0.000),bilirubin level(P=0.017),peritoneal metastasis(P=0.009),portal vein metastasis(P=0.004) were related to the prognosis of hepatitis B-related HCC patients treated with TACE.Conclusion Higher bilirubin level,intra-abdominal metastasis and portal vein metastasis may be independent risk factors affecting the prognosis of patients with hepatitis B-related HCC treated with TACE,while antiviral therapy and more times of interventional therapies may be the protective factors.
作者
郭俊
宋书红
张丽
杨靖
GUO Jun;SONG Shu-hong;ZHANG Li;YANG Jing(Department of Oncology,Dongfeng Hospital Affiliated to Hubei University of Medicine,Shiyan,Hubei 442010,China)
出处
《中国临床研究》
CAS
2019年第3期317-320,共4页
Chinese Journal of Clinical Research
基金
2018年度湖北省教育厅科研计划项目(B2018117)~~
关键词
肝肿瘤
乙型肝炎
经导管肝动脉化疗栓塞
预后
Hepatocellular carcinoma
Hepatitis B
Transcatheter arterial chemoembolization
Prognosis
