中华肝脏病杂志
中華肝髒病雜誌
중화간장병잡지
CHINESE JOURNAL OF HEPATOLOGY
2011年
10期
759-763
,共5页
常秀娟%陆荫英%白文林%陈艳%安林静%周霖%王鋐%吴煜%刘泽%楼敏%曾珍%苏淑慧%曲建慧%杨永平
常秀娟%陸蔭英%白文林%陳豔%安林靜%週霖%王鋐%吳煜%劉澤%樓敏%曾珍%囌淑慧%麯建慧%楊永平
상수연%륙음영%백문림%진염%안림정%주림%왕횡%오욱%류택%루민%증진%소숙혜%곡건혜%양영평
癌,肝细胞%冷冻外科手术%生存率%进展时间
癌,肝細胞%冷凍外科手術%生存率%進展時間
암,간세포%냉동외과수술%생존솔%진전시간
Carcinoma,hepatocellular%Cryosurgery,Survival rate,Time to progression
目的 探讨氩氦冷冻消融治疗进展期肝细胞癌(HCC)的临床疗效,并分析影响其疗效的预测因素. 方法 对2005-2008年在我院治疗的190例乙型肝炎相关进展期HCC患者采用临床队列方法,分为氩氦冷冻消融治疗组(147例)和对照组(43例),比较两组中位生存期(OS)和肿瘤进展时间(TTP),评价年龄、性别、门静脉癌栓位置、HBeAg状态、肿瘤组织分化程度、Child-Pugh分级、终末期肝病模型(MELD)评分、进展期肝癌预测系统(ALCPS)评分及东部肿瘤协作组体能状态(ECOG PS)评分对冷冻消融疗效预测的影响.组间率的比较用x2检验;生存分析用Kaplan-Meier法,生存率的比较用Log-rank分析;多因素对生存期的影响用Cox回归模型进行分析. 结果 冷冻消融治疗组和对照组患者中位OS分别为7.5 (4.2～ 14.6)个月和3.2 (1.2 ～ 8.6)个月,中位TTP分别为3.5 (2.5 ～ 4.5)个月和1.5 (1.0 ～ 3.5)个月,差异均有统计学意义(P值均＜0.05).肿瘤细胞高分化、Child-pugh A级及MELD评分、ALCPS评分和ECOG PS评分好的进展期HCC患者中位OS和TTP明显长于肿瘤细胞低分化、Child-pugh B级及各系统评分差的患者(P值均＜ 0.05).对进展期HCC患者的OS具有独立预测作用的因素为ECOG PS(P＜0.05,95％可信区间为1.074 ～ 2.143)和ALCPS(P＜0.05,95％可信区间为1.005 ～ 2.121).结论 冷冻消融治疗进展期HCC能够延长患者中位OS和TTP; ECOG PS和ALCPS评分系统是进展期HCC患者OS的重要预测因素.
目的 探討氬氦冷凍消融治療進展期肝細胞癌(HCC)的臨床療效,併分析影響其療效的預測因素. 方法 對2005-2008年在我院治療的190例乙型肝炎相關進展期HCC患者採用臨床隊列方法,分為氬氦冷凍消融治療組(147例)和對照組(43例),比較兩組中位生存期(OS)和腫瘤進展時間(TTP),評價年齡、性彆、門靜脈癌栓位置、HBeAg狀態、腫瘤組織分化程度、Child-Pugh分級、終末期肝病模型(MELD)評分、進展期肝癌預測繫統(ALCPS)評分及東部腫瘤協作組體能狀態(ECOG PS)評分對冷凍消融療效預測的影響.組間率的比較用x2檢驗;生存分析用Kaplan-Meier法,生存率的比較用Log-rank分析;多因素對生存期的影響用Cox迴歸模型進行分析. 結果 冷凍消融治療組和對照組患者中位OS分彆為7.5 (4.2～ 14.6)箇月和3.2 (1.2 ～ 8.6)箇月,中位TTP分彆為3.5 (2.5 ～ 4.5)箇月和1.5 (1.0 ～ 3.5)箇月,差異均有統計學意義(P值均＜0.05).腫瘤細胞高分化、Child-pugh A級及MELD評分、ALCPS評分和ECOG PS評分好的進展期HCC患者中位OS和TTP明顯長于腫瘤細胞低分化、Child-pugh B級及各繫統評分差的患者(P值均＜ 0.05).對進展期HCC患者的OS具有獨立預測作用的因素為ECOG PS(P＜0.05,95％可信區間為1.074 ～ 2.143)和ALCPS(P＜0.05,95％可信區間為1.005 ～ 2.121).結論 冷凍消融治療進展期HCC能夠延長患者中位OS和TTP; ECOG PS和ALCPS評分繫統是進展期HCC患者OS的重要預測因素.
목적 탐토아양냉동소융치료진전기간세포암(HCC)적림상료효,병분석영향기료효적예측인소. 방법 대2005-2008년재아원치료적190례을형간염상관진전기HCC환자채용림상대렬방법,분위아양냉동소융치료조(147례)화대조조(43례),비교량조중위생존기(OS)화종류진전시간(TTP),평개년령、성별、문정맥암전위치、HBeAg상태、종류조직분화정도、Child-Pugh분급、종말기간병모형(MELD)평분、진전기간암예측계통(ALCPS)평분급동부종류협작조체능상태(ECOG PS)평분대냉동소융료효예측적영향.조간솔적비교용x2검험;생존분석용Kaplan-Meier법,생존솔적비교용Log-rank분석;다인소대생존기적영향용Cox회귀모형진행분석. 결과 냉동소융치료조화대조조환자중위OS분별위7.5 (4.2～ 14.6)개월화3.2 (1.2 ～ 8.6)개월,중위TTP분별위3.5 (2.5 ～ 4.5)개월화1.5 (1.0 ～ 3.5)개월,차이균유통계학의의(P치균＜0.05).종류세포고분화、Child-pugh A급급MELD평분、ALCPS평분화ECOG PS평분호적진전기HCC환자중위OS화TTP명현장우종류세포저분화、Child-pugh B급급각계통평분차적환자(P치균＜ 0.05).대진전기HCC환자적OS구유독립예측작용적인소위ECOG PS(P＜0.05,95％가신구간위1.074 ～ 2.143)화ALCPS(P＜0.05,95％가신구간위1.005 ～ 2.121).결론 냉동소융치료진전기HCC능구연장환자중위OS화TTP; ECOG PS화ALCPS평분계통시진전기HCC환자OS적중요예측인소.
Objectives Investigate the clinical efficacy of cryotherapy ablation treatment for advanced hepatocellular carcinoma.analyse the predictive factors of cryotherapy ablation treatment.Methods There were 190 cases of hepatitis B-related HCC patients with advanced HCC from 2005 to 2008 in our hospital.By using clinical cohort method,they included cryoablation group (147 eases) and control group (43 cases),The median survival time and time to disease progression were compared.Evaluate clinical significance of age,gender,location of portal vein tumor thrombus,HBeAg,tumor histological grade,Child-Pugh classification,end-stage liver disease (MELD) score,advanced liver cancer prediction system (ALCPS) score and the Eastern Cooperative Oncology Group performance status (ECOG PS) score for predicting the efficacy of eryoablation.Group rates were compared with the x 2 test,survival analysis by using Kaplan-Meier method,survival rates were compared by Log-rank analysis; multiple factor survival analysis by using Cox regression model.Results Median survival time of cryoablation goup and Control group was 7.5 (4.2 to 14.6) months and 3.2 (1.2 to 8.6) months,median TTP was 3.5 (2.5 to 4.5) months and 1.5 (1.0 to 3.5 months),the differences were statistically significant (P ＜0.05 ).Median OS and TTP of advanced HCC patients who had Well-differentiated tumor,Child-pugh A-class and low score of MELD score,ALCPS score,ECOG PS score were significantly longer than the poorly differentiate,Child-Pugh B-class and the high those scores (P＜0.05).ECOG PS (P＜0.05,95％ CI 1.074 ～ 2.143) and ALCPS (P＜0.05,95％ CI 1.005 - 2.121) were independent predictors for OS of advanced HCC.Conclusions Cryoablation treatment can prolong median OS and TTP of advanced HCC; ECOG PS and ALCPS are important predictors for survival time of advanced HCC.
