中华普通外科杂志
中華普通外科雜誌
중화보통외과잡지
CHINESE JOURNAL OF GENERAL SURGERY
2015年
3期
185-188
,共4页
杨浩洁%郭哲%姜经航%杨富权%鲍思扬%黎乐群%赵昌%向邦德
楊浩潔%郭哲%薑經航%楊富權%鮑思颺%黎樂群%趙昌%嚮邦德
양호길%곽철%강경항%양부권%포사양%려악군%조창%향방덕
癌,肝细胞%化学栓塞,治疗性%抗肿瘤联合化疗方案
癌,肝細胞%化學栓塞,治療性%抗腫瘤聯閤化療方案
암,간세포%화학전새,치료성%항종류연합화료방안
Carcinoma,hepatocellular%Chemoembolization,therapeutic%Antineoplastic combined chemotherapy protocals
目的 探讨巴塞罗那分期(Barcelona Clinical Liver Cancer Staging System,BCLC)A期肝癌患者经肝动脉化疗栓塞(transarterial chemoembolization,TACE)治疗预后的影响因素. 方法 回顾性分析274例经TACE治疗的BCLC A期肝癌患者的临床资料.结果 BCLC A期肝癌患者术后1、3、5年生存率分别为51.6％、21.2％、11.8％.单因素分析表明术前白蛋白≤35 g/L(x2=6.736,P=0.009)、天冬氨酸转氨酶≥70 U/L(x2=8.295,P=0.004)、肿瘤直径≥5 cm(x2=6.720,P=0.010)、AFP≥400 ng/ml(x2=12.510,P=0.000)影响BCLC A期肝癌患者术后累积生存率.多因素分析表明术前白蛋白≤35 g/L(Wald=9.827,P=0.002)、肿瘤直径≥5 cm(Wald=5.680,P=0.017)、AFP(α-fetoprotein)≥400 ng/ml(Wald=10.359,P=0.001)是影响上述患者预后的独立危险因素.另外,满足白蛋白＞ 35 g/L、肿瘤直径＜5 cm、AFP ＜400 ng/ml的BCLC A期患者1、3、5年生存率为83.3％、61.1％、30％.结论 术前白蛋白≤35 g/L、肿瘤直径≥5 cm、AFP≥400 ng/ml是影响BCLC A期肝癌患者预后的独立危险因素;对于满足白蛋白＞ 35 g/L、肿瘤直径＜5 cm、AFP＜ 400 ng/ml的BCLC A期肝癌患者,TACE是一种安全、有效的治疗手段.
目的 探討巴塞囉那分期(Barcelona Clinical Liver Cancer Staging System,BCLC)A期肝癌患者經肝動脈化療栓塞(transarterial chemoembolization,TACE)治療預後的影響因素. 方法 迴顧性分析274例經TACE治療的BCLC A期肝癌患者的臨床資料.結果 BCLC A期肝癌患者術後1、3、5年生存率分彆為51.6％、21.2％、11.8％.單因素分析錶明術前白蛋白≤35 g/L(x2=6.736,P=0.009)、天鼕氨痠轉氨酶≥70 U/L(x2=8.295,P=0.004)、腫瘤直徑≥5 cm(x2=6.720,P=0.010)、AFP≥400 ng/ml(x2=12.510,P=0.000)影響BCLC A期肝癌患者術後纍積生存率.多因素分析錶明術前白蛋白≤35 g/L(Wald=9.827,P=0.002)、腫瘤直徑≥5 cm(Wald=5.680,P=0.017)、AFP(α-fetoprotein)≥400 ng/ml(Wald=10.359,P=0.001)是影響上述患者預後的獨立危險因素.另外,滿足白蛋白＞ 35 g/L、腫瘤直徑＜5 cm、AFP ＜400 ng/ml的BCLC A期患者1、3、5年生存率為83.3％、61.1％、30％.結論 術前白蛋白≤35 g/L、腫瘤直徑≥5 cm、AFP≥400 ng/ml是影響BCLC A期肝癌患者預後的獨立危險因素;對于滿足白蛋白＞ 35 g/L、腫瘤直徑＜5 cm、AFP＜ 400 ng/ml的BCLC A期肝癌患者,TACE是一種安全、有效的治療手段.
목적 탐토파새라나분기(Barcelona Clinical Liver Cancer Staging System,BCLC)A기간암환자경간동맥화료전새(transarterial chemoembolization,TACE)치료예후적영향인소. 방법 회고성분석274례경TACE치료적BCLC A기간암환자적림상자료.결과 BCLC A기간암환자술후1、3、5년생존솔분별위51.6％、21.2％、11.8％.단인소분석표명술전백단백≤35 g/L(x2=6.736,P=0.009)、천동안산전안매≥70 U/L(x2=8.295,P=0.004)、종류직경≥5 cm(x2=6.720,P=0.010)、AFP≥400 ng/ml(x2=12.510,P=0.000)영향BCLC A기간암환자술후루적생존솔.다인소분석표명술전백단백≤35 g/L(Wald=9.827,P=0.002)、종류직경≥5 cm(Wald=5.680,P=0.017)、AFP(α-fetoprotein)≥400 ng/ml(Wald=10.359,P=0.001)시영향상술환자예후적독립위험인소.령외,만족백단백＞ 35 g/L、종류직경＜5 cm、AFP ＜400 ng/ml적BCLC A기환자1、3、5년생존솔위83.3％、61.1％、30％.결론 술전백단백≤35 g/L、종류직경≥5 cm、AFP≥400 ng/ml시영향BCLC A기간암환자예후적독립위험인소;대우만족백단백＞ 35 g/L、종류직경＜5 cm、AFP＜ 400 ng/ml적BCLC A기간암환자,TACE시일충안전、유효적치료수단.
Objective To study prognostic factors in BCLC (Barcelona Clinical Liver Cancer Staging System) stage A hepatocellular carcinoma (HCC)patients treated with TACE (transarterial chemoembolization).Methods The clinical data of 274 patients with BCLC stage A HCC treated with TACE were retrospectively analyzed.Results The 1-,3-and 5-year overall survival rates were 51.6％,21.2％ and 11.8％,respectively.According to the log-rank test,preoperative serum albumin level ≤ 35 g/L(x2 =6.736,P =0.009),preoperative serum AST (aspartate aminotransferase) ≥ 70 U/L (x2 =8.295,P =0.004)、tumor size ≥ 5 cm (x2 =6.720,P =0.010) and AFP (α-fetoprotein)level ≥ 400 ng/ml (x2 =12.510,P =0.000) were significantly associated with prognosis of stage A HCC,and Cox regression indicated that independent prognostic factors included serum albumin level ≤ 35 g/L (Wald =9.827,P =0.002),tumor size ≥ 5 cm (Wald =5.680,P =0.017) and AFP (α-fetoprotein)level ≥400 ng/ml (Wald =10.359,P =0.001).The 1-,3-and 5-year overall survival rate for BCLC stage A HCC patients with serum albumin level ＞ 35 g/L,AFP level ＜ 400 ng/ml and tumor size ＜ 5 cm was 83.3％,61.1％ and 30％,respectively.Conclusions Serum albumin level ≤35 g/L,AFP level ≥ 400 ng/ml and tumor size ≥ 5 cm were the main risk factors affecting the prognosis.TACE is an effective treatment for BCLC stage A HCC with serum albumin level ＞ 35 g/L,AFP level ＜ 400 ng/ml and tumor size ＜5 cm.
