【摘要】 目的 探讨手术切除联合术后肝动脉化疗栓塞术(TACE)治疗原发性肝细胞癌的临床效果。方法 收集2008年4月至2010年3月广西医科大学第一附属医院肝胆外科收治的82例巴塞罗那临床肝癌分期(BCLC)A期原发性肝细胞癌患者的临床资料进行回顾性分析,根据肝癌切除术后是否联合TACE治疗分为观察组(40例)和对照组(42例),观察组进行手术切除联合术后TACE,对照组仅进行手术切除,术后常规随访。比较2组患者术后1、3、5年生存率和术后并发症发生情况;采用简单线性回归及COX多因素回归分析患者肝癌切除术后预后的影响因素。结果 观察组术后1、3、5年生存率均明显高于对照组[90.0%(36/40)比66.7%(28/42)、75.0%(30/40)比40.5%(17/42)、52.5%(21/40)比19.0%(8/42)],差异均有统计学意义(均P<0.05)。2组术后并发症发生率差异均无统计学意义(均P>0.05)。术前甲胎蛋白水平、肝功能Child-Pugh分级、肿瘤个数、肿瘤直径和术后行TACE是影响患者肝癌切除术后预后的独立危险因素(均P<0.05)。结论对于BCLC-A期的原发性肝细胞癌患者,手术切除后联合TACE治疗可明显提高术后生存率。更多还原

【Abstract】 Objective To investigate the curative effect of surgical resection combined with postoperative transcatheter arterial chemoembolization(TACE) on primary hepatoma.Methods Totally 82 cses of Barcelona Clinic Liver Cancer(BCLC) stage A primary hepatoma from April 2008 to March 2010 in the First Affiliated Hospital of Guangxi Medical University were retrospectively analyzed.All patients were divided into observation group(40 cases,treated with surgical resection combined with TACE) and control group(40 cases,treated with surgical resection).Postoperative 1-,3-,5-year survival rates and complications were recorded.Prognostic factors of hepatectomy were analyzed.Results Postoperative 1-,3-,5-year survival rates in observation group were significantly higher than those in control group[90.0%(36/40) vs 66.7%(28/42),75.0%(30/40) vs 40.5%(17/42),52.5%(21/40) vs 19.0%(8/42)](P<0.05).There was no significant difference of complication incidence between groups(P >0.05).Preoperative alpha-fetoprotein level,Child-Pugh classification of liver function,tumor numbers,tumor size and postoperative TACE were independent prognostic factors of hepatectomy(P <0.05).Conclusion Surgical resection combined with postoperative TACE can significantly improve the survival rate of patients with BCLC-A primary hepatoma.更多还原