原发性肝癌介入治疗的研究分析
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摘要
目的:回顾性分析比较TACE、TACE+PEI及PEI三种介入方案对原发性肝癌(PLC)的疗效,综合分析预后影响因素。旨在合作探索出一套规范化的介入治疗模式,提高肝癌治疗的效果,推动肝癌介入治疗规范化的实施,以及为预后的评估提供一定的理论依据。
方法:回顾性分析98例住院进行TACE、PEI或TACE+PEI介入方案治疗的PLC病例,记录患者一般资料、治疗情况、肿瘤情况、检查情况等,并观察患者病情的变化情况。对影响肝癌治疗及预后的相关因素行Cox回归分析。
结果:三组相比,以TACE+PEI组疗效最好、生存率最高、中位生存期最长,AFP改善以及肝功能分级改善情况最佳。Cox回归单因素分析显示,对预后有显著影响的因素:有无癌栓、治疗后肿瘤缩小率、是否行TACE+PEI治疗及治疗后AFP值;多因素分析示:有无癌栓、是否行TACE+PEI治疗对预后有重要意义。
结论:三组相比,TACE+PEI组疗效显著优于单纯TACE或PEI组,治疗后AFP及肝功能改善情况亦优于单纯TACE或PEI组,患者生存期相对较长。影响肝癌介入治疗预后的重要因素是:有无癌栓和TACE+PEI治疗方式。
OBJECTIVE : Comparing of TACE , TACE+PEI and PEI three interventional treatments for primary liver carcinoma(PLC),comprehensivly analysing major factors which influenced prognosis,in order to cooperation exploring the involvement of a set of standardized treatment modalities, the elevation of interventional therapeutic effects, promote the implementation of standardized and provide a theory-based evidence for the estimation of prognosis.
METHODS:98 PLC patients treated with TACE,PEI or TACE+PEI were studied retrospectively,Records of patients with general information, treatment, tumor cases, inspection, etc. And to observe changes in patients. Cox regression analysis of the impact on the treatment and prognostic of liver cancer-related factors.
RESULTS:Of the three groups,TACE+PEI group obtained the best curative effect,the highest survival rate and the longest middle life span;The best achievement on the loss degree of AFP value and the improvement of Liver functional classification also happened in TACE+PEI group.Cox regression simplex actor analysis display significantly influential factors such as carcinoma lock,tumour diminution rate,TACE+PEI treatment and AFP value of post-treatment , Multiplicity display that carcinoma lock and TACE+PEI treatment two factors make sense to prognosis.
CONCLUSION:Of the three groups,TACE + PEI method have notably curative effect,with TACE+PEI method the loss degree of AFP value after treatment and the improvement of Liver function on paients also obviously better than with either TACE or PEI;besides,this treatment can prolong sufferers’life span notably.The impact of intervention in the treatment of liver cancer prognosis is an important factor: the availability of tumor thrombus and TACE + PEI treatment.
方法:回顾性分析98例住院进行TACE、PEI或TACE+PEI介入方案治疗的PLC病例,记录患者一般资料、治疗情况、肿瘤情况、检查情况等,并观察患者病情的变化情况。对影响肝癌治疗及预后的相关因素行Cox回归分析。
结果:三组相比,以TACE+PEI组疗效最好、生存率最高、中位生存期最长,AFP改善以及肝功能分级改善情况最佳。Cox回归单因素分析显示,对预后有显著影响的因素:有无癌栓、治疗后肿瘤缩小率、是否行TACE+PEI治疗及治疗后AFP值;多因素分析示:有无癌栓、是否行TACE+PEI治疗对预后有重要意义。
结论:三组相比,TACE+PEI组疗效显著优于单纯TACE或PEI组,治疗后AFP及肝功能改善情况亦优于单纯TACE或PEI组,患者生存期相对较长。影响肝癌介入治疗预后的重要因素是:有无癌栓和TACE+PEI治疗方式。
OBJECTIVE : Comparing of TACE , TACE+PEI and PEI three interventional treatments for primary liver carcinoma(PLC),comprehensivly analysing major factors which influenced prognosis,in order to cooperation exploring the involvement of a set of standardized treatment modalities, the elevation of interventional therapeutic effects, promote the implementation of standardized and provide a theory-based evidence for the estimation of prognosis.
METHODS:98 PLC patients treated with TACE,PEI or TACE+PEI were studied retrospectively,Records of patients with general information, treatment, tumor cases, inspection, etc. And to observe changes in patients. Cox regression analysis of the impact on the treatment and prognostic of liver cancer-related factors.
RESULTS:Of the three groups,TACE+PEI group obtained the best curative effect,the highest survival rate and the longest middle life span;The best achievement on the loss degree of AFP value and the improvement of Liver functional classification also happened in TACE+PEI group.Cox regression simplex actor analysis display significantly influential factors such as carcinoma lock,tumour diminution rate,TACE+PEI treatment and AFP value of post-treatment , Multiplicity display that carcinoma lock and TACE+PEI treatment two factors make sense to prognosis.
CONCLUSION:Of the three groups,TACE + PEI method have notably curative effect,with TACE+PEI method the loss degree of AFP value after treatment and the improvement of Liver function on paients also obviously better than with either TACE or PEI;besides,this treatment can prolong sufferers’life span notably.The impact of intervention in the treatment of liver cancer prognosis is an important factor: the availability of tumor thrombus and TACE + PEI treatment.
引文
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[5] Ya-Min Liu,Hao Qin,Chong-Bao Wang, et a.Comparison of therapeutic efectiveness of combined interventional therapy for 1126 cases of primary liver cancer.World J Gastroentero1 , 2006,12(31):5060～5063.
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