肝癌术后肝动脉化疗栓塞治疗患者肿瘤复发的影响因素分析
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摘要
目的探讨影响肝癌术后经导管肝动脉化疗栓塞治疗(TACE)患者肿瘤复发的危险因素。方法选择并收集200例肝癌患者的年龄、性别等一般人口学特征和临床特征资料并对患者进行随访追踪,采用Logistic逐步回归分析法分析肿瘤复发的影响因素。结果在200例患者中130例有肿瘤复发,占65.0%。Logistic逐步回归分析结果显示,血管癌栓(OR=3.796;95%CI:1.871~7.702)、侵透肝被膜(OR=3.340;95%CI:1.067~10.451)、肝硬化(OR=2.790;95%CI:1.771~4.396)、包膜完整性(OR=2.048;95%CI:1.273~3.298)和最大癌结节直径(OR=1.739;95%CI:1.014~2.980)是肝癌术后TACE治疗患者肿瘤复发的危险因素。结论肝癌术后TACE治疗患者的肿瘤复发率较高,术前有无血管癌栓、侵透肝被膜和肝硬化,包膜是否完整,以及肿瘤的直径等均会影响肿瘤复发,临床需要加强患者术后复诊和康复治疗。
Objective To explore the risk factors of postoperative recurrence of patients with hepatocellular carcinoma after transcatheter hepatic arterial chemoembolization(TACE). Method A total of 200 patients with liver cancer were included in this study. The demographic and clinical characteristics of the patients were collected and the patients were followed up. Logistic stepwise regression was used to analyze the risk factors. Result Of the 200 subjects, 130 patients had tumor recurrence, accounting for 65.0%. Logistic regression analysis showed that the vascular tumor thrombus(OR=3.796; 95%CI: 1.871~7.702), liver capsule invasion(OR=3.340; 95%CI: 1.067~10.451), cirrhosis(OR=2.790; 95%CI:1.771~4.396), capsule integrity(OR=2.048; 95% CI: 1.273~3.298) and maximal nodule diameter(OR=1.739; 95% CI:1.014~2.980), and were risk factors in patients with recurrence after postoperative TACE. Conclusion The recurrence rate of hepatocellular carcinoma after TACE is relatively high, the presence of vascular tumor thrombus, liver capsule invasion, cirrhosis, capsule integrity and the diameter of tumor will influence the recurrence rate, so the postoperative visits and rehabilitation treatment should be addressed.
Objective To explore the risk factors of postoperative recurrence of patients with hepatocellular carcinoma after transcatheter hepatic arterial chemoembolization(TACE). Method A total of 200 patients with liver cancer were included in this study. The demographic and clinical characteristics of the patients were collected and the patients were followed up. Logistic stepwise regression was used to analyze the risk factors. Result Of the 200 subjects, 130 patients had tumor recurrence, accounting for 65.0%. Logistic regression analysis showed that the vascular tumor thrombus(OR=3.796; 95%CI: 1.871~7.702), liver capsule invasion(OR=3.340; 95%CI: 1.067~10.451), cirrhosis(OR=2.790; 95%CI:1.771~4.396), capsule integrity(OR=2.048; 95% CI: 1.273~3.298) and maximal nodule diameter(OR=1.739; 95% CI:1.014~2.980), and were risk factors in patients with recurrence after postoperative TACE. Conclusion The recurrence rate of hepatocellular carcinoma after TACE is relatively high, the presence of vascular tumor thrombus, liver capsule invasion, cirrhosis, capsule integrity and the diameter of tumor will influence the recurrence rate, so the postoperative visits and rehabilitation treatment should be addressed.
引文
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[15]李加洲.原发性肝癌术后复发的相关因素分析[J].中国医药指南,2012,10(31):587-589.
[2]Walter SR,Thein HH,Gidding HF,et al.Risk factors for hepatocellular carcinoma in a cohort infected with hepatitis B or C[J].J Gastroenterol Hepatol,2011,26(12):1757-1764.
[3]魏东庆.肝细胞肝癌根治性切除术后复发时间和复发类型影响因素的探讨[D].福州:福建医科大学,2011.
[4]仲杨.小肝癌根治术后早期复发转移预测的数学模型研究[D].福州:福建医科大学,2012.
[5]邱谢武,于聪慧.肝癌干细胞与肝癌复发转移的研究进展[J].世界华人消化杂志,2011,19(17):1802-1807.
[6]杨浩,杨连粤.肝癌术后复发转移相关因素研究进展[J].中国实用外科杂志,2012,32(10):868-870.
[7]黎鹏飞.大肝细胞性肝癌术后早期复发转移的相关危险因素分析[D].福州:福建医科大学,2013.
[8]袁克文,王湘辉,肖毅,等.原发性肝癌术后复发现状和影响因素分析[J].检验医学与临床,2013,10(17):2248-2249.
[9]沈锋,奚韬.肝癌切除术后抗复发治疗[J].中国实用外科杂志,2008,88(12):1029-1031.
[10]苏成豪.厦门地区HBV感染、环境因素及基因多态性与原发性肝癌的关联研究[D].福州:福建医科大学,2015.
[11]邓鹏.原发性肝癌复发的再切除治疗[D].重庆:重庆医科大学,2012.
[12]钱跹.原发性肝癌患者体内甾体激素水平与肝癌病程及术后复发的相关性研究[D].上海:第二军医大学,2014.
[13]郑江华,王广义.肝癌术后转移复发相关因素的研究进展[J].实用医学杂志,2010,26(12):2239-2241.
[14]贾户亮,钦伦秀.肝癌术后复发影像学早期诊断及其评价[J].中国实用外科杂志,2012,32(10):817-821.
[15]李加洲.原发性肝癌术后复发的相关因素分析[J].中国医药指南,2012,10(31):587-589.