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目的:对原发性肝细胞肝癌(HCC)肝部分切除术后行经肝动脉化疗栓塞(TACE)的病人和未行TACE病人影响其预后的多种因素进行分析和评价,为肝切除术后是否行TACE治疗寻找筛选条件。方法:对我院2003～2008年期间在我院肝胆外科行原发性肝细胞肝癌手术治疗221例(术后介入治疗103例,术后非介入治疗118例)患者进行全面随访了解患者的预后情况,分别对术后接受介入治疗和非介入治疗两组通过Kaplan-Meier及COX回归分析影响预后的因素,包括:年龄、性别、血清HBsAg、肿瘤直径、肿瘤大体分型、有无癌栓形成,肿瘤分期(TNM)共7项指标。结果:在1年生存期内介入治疗组中的性别、年龄、血清HBsAg、肿瘤直径、肿瘤大体分型无统计学意义(p>0.05),有无癌栓形成及肿瘤分期有意义(p<0.05);非介入组内年龄、性别、血清HBsAg无统计学意义,肿瘤直径、肿瘤大体分型、有无癌栓形成,肿瘤分期有意义;在3年生存期内介入治疗组中的以上指标无统计学意义,而非介入组在肿瘤直径、有癌栓形成及肿瘤分期方面与统计学意义。结论:对于肿瘤直径>5cm及术后病理证实为低分化的患者给予积极TACE治疗可明显提高近期生存率。
OBJECTIVE: To analyze and evaluate the factors that influence the prognosis of patients with hepatocellular carcinoma (HCC) after partial hepatectomy via transcatheter arterial chemoembolization (TACE) and those without TACE TACE treatment to find the screening conditions. Methods: A total of 221 patients (103 postoperative interventional procedures and 118 postoperative non-interventional treatments) undergoing surgical treatment of hepatocellular carcinoma in our hospital from 2003 to 2008 were enrolled in this study. The prognosis The factors affecting the prognosis were analyzed by Kaplan-Meier and COX regression analysis, including age, gender, serum HBsAg, tumor diameter, tumor type, and the presence or absence of thrombosis , Tumor staging (TNM) a total of seven indicators. Results: The gender, age, serum HBsAg, tumor diameter and gross tumor classification in the intervention group were not statistically significant (p> 0.05), with or without thrombosis and tumor stage (p < 0.05). The age, gender and serum HBsAg of the non-intervention group were not statistically significant, the diameter of the tumor, the general classification of the tumor, the presence or absence of thrombosis, and the staging of the tumor were significant. In the 3-year survival period, Not statistically significant, but not involved in the group of tumor diameter, tumor thrombosis and tumor staging with statistical significance. Conclusion: The positive TACE treatment for patients with tumor diameter> 5 cm and poorly differentiated pathology after surgery may improve the short-term survival rate significantly.