摘要
目的：对接受动脉化疗栓塞术（TACE）治疗的伴门脉癌栓（PVTT）的原发性肝细胞癌（HCC）的潜在预后因子进行研究，并且对比TACE治疗首发癌栓及迟发癌栓肝癌患者的生存分析。方法：回顾性分析2007年1月—2013年3月临床资料完整、伴有PVTT并接受TACE治疗的HCC患者57例，建立病例资料数据库，TACE治疗后局部肿瘤的反应通过mRECIST标准评估。应用寿命表法计算生存期。对相关因素采用Kaplan-Meier检验进行生存率的单因素分析以及COX风险比例模型进行多因素分析，筛选出独立预后因素。结果：根据mRECIST标准完全反应者（CR）1例（1.5%），部分反应者（PR）14例（24.5%），稳定者（SD）20例（35.5%），进展者（PD）22例（38.5%）。6、12、18、24月的生存率分别为50.8%、29.8%、24.6%、10.5%，中位生存时间为6.8月。在多因素分析中，谷草转氨酶、胆碱酯酶、动静脉瘘、门脉主干闭塞、局部肿瘤反应均为影响患者的预后因素。结论：多个影响因素都会对PVTT的HCC患者生存时间造成影响，TACE治疗首发癌栓及迟发癌栓肝癌患者的生存率无差别。
Abstract
Objective: To evaluate the clinical prognosis and survival outcomes of hepatocellular carcinoma(HCC) patients with portal vein tumor thrombosis(PVTT). And to compare survival rate between groups of synchronous and asynchronous PVTT. Methods: A prognostic model was developed for 57 HCC patients with PVTT treated with transcatheter arterial chemoembolization(TACE) from 2007 January to 2013 March. Local tumor response was evaluated by modified response evaluation criteria in solid tumor. Clinical characteristics, prognosis, and patient survival were analyzed by the life table method, the Kaplan-Meier method and Cox’s proportional hazards model. Results: According to mRECIST, complete response, partial response, stable disease and progressive disease were found in 1 patient(1.5%), 14 patients(24.5%), 20 patients(35.5%) and 22 patients(38.5%), respectively. The 6-, 12-, 18- and 24-month overall survivals for the HCC patients with PVTT after TACE were 50.8%, 29.8%, 24.6% and 10.5%, respectively. The median survival was 6.8 months. In the multivariate analysis, pre-treatment prognostic factors for overall survival were AST, CHE, APS, complete portal vein occlusion and local tumor response. Conclusion: There are many factors affecting the survival outcomes of HCC patients with PVTT, and there is no difference in survival analysis study between synchronous and asynchronous portal vein tumor thrombosis.
关键词
肝肿瘤 /
栓塞 /
治疗性 /
放射学 /
介入性
Key words
Liver neoplasms /
Embolization /
therapeutic /
Radiology /
interventional
崔 鹏;刘晓霞;杜小丽;张建明;卢再鸣.
肝动脉化疗栓塞治疗肝癌合并门脉癌栓患者的生存分析[J]. 中国临床医学影像杂志. 2014, 25(2): 92-97
CUI Peng;LIU Xiao-xia;DU Xiao-li;ZHANG Jian-ming;LU Zai-ming.
Prognostic factors for portal vein tumor thrombosis in patients with hepatocellular carcinoma receiving transcatheter arterial chemoembolization therapy[J]. Journal of China Clinic Medical Imaging. 2014, 25(2): 92-97
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