【摘要】 目的探讨肝细胞癌(HCC)患者行外科手术切除后5年生存情况的独立影响因素。方法收集我院2008年10月~2010年10月收治的112例接受外科手术治疗的HCC患者的临床资料,行腹部CTA检查,观察患者相关临床指标,运用Cox风险比例回归模型进行单因素和多因素分析,得出独立影响因素,运用Kaplan-Meier法和Log-Rank检验比较这些因素在生存曲线分布上的变化情况。结果多因素Cox回归模型分析结果显示,微血管浸润、肿瘤数目、肿瘤大小、肿瘤细胞分化程度和术后行肝动脉灌注化疗栓塞术(TACE)为影响此类患者生存情况的独立影响因素,其OR值分别为2.61、2.57、2.01、1.37、0.31,Kaplan-Meier法和Log-Rank检验显示38例TACE治疗组1 a、3 a、5 a累计生存率分别为90.6%、83.2%、80.5%,显著高于74例未行TACE治疗组的88.2%、41.5%、30.9%(P<0.05)。结论肝癌根治术后给予TACE治疗可提高HCC患者生存率,延长生存期,有助于改善患者预后。更多还原

【Abstract】 Objective To investigate the independent affecting factors of survival of patients with hepatocellular carcinoma(HCC) in five years after radical surgical resection. Methods A total of 112 patients with HCC after radical surgical resection in our hospital between October 2008 and October 2010 were enrolled in this study. Possible prognostic risk factors were obtained through clinical observation. Then,the univariate and multivariate survival analysis were performed using Cox regression model. Based on the multivariate analysis results,we compared the changes of survival curves between independent factors using Kaplan-Meier method and Log-Rank test. Results Multiple Cox regression analysis showed that there were five independent factors affecting the prognosis of patients with HCC in five years after radical surgical resection,which were microvascular invasion(MVI),the mass of tumors,the maximum diameters of tumors,histological differentiation,transcatheter arterial chemoembolization(TACE),and the OR were 2.61,2.57,2.01,1.37 and 0.31,respectively. Kaplan-Meier method and Log-Rank test results showed the cumulative survival rates at 1 a,3 a and 5 a in 38 TACE-treated patients were90.6%,83.2% and 80.5%,much higher than 88.2%,41.5% and 30.9%,respectively,in 74 patients without TACE treatment(all P<0.05). Conclusions The TACE treatment can improve the prognosis of patients with HCC in five years after radical surgical resection.更多还原