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目的 综合评价各预后因素对中晚期原发性肝癌生存期的影响。方法 无外科手术指征 ,有介入化疗指征的 98例原发性肝癌患者 ,按自愿原则行介入或非介入治疗 ,观察其生存时间 ,以Kaplan Meier法描述生存曲线 ,并收集可能影响预后的 31个因素的全部资料 ,运用Cox回归模型进行回顾性统计分析。结果 全组 0 .5、1、2和 3年累计生存率分别为 57.1 %、2 9.6 %、1 4 .3 %和 6 .1 % ,平均生存期为 1 0 .7个月。Cox回归模型单因素分析显示肿瘤直径等共 1 9项预后因素有统计差异 ,而多因素分析认为 ,肿瘤直径、治疗后直径差值、介入治疗次数、门静脉主干癌栓、家庭人均收入和生活质量改善等 6项有显著统计差异。结论 除治疗前后的肿瘤直径、介入治疗次数、门脉主干癌栓等临床因素外 ,患者的经济状况、生活质量等非临床因素对预后也有很大影响
Objective To comprehensively evaluate the effect of various prognostic factors on the survival period of advanced primary liver cancer. Methods There were 98 patients with primary liver cancer who had no indications for interventional chemotherapy. Voluntary guidelines were used for intervention or non-invasive treatment. The survival time was observed. The Kaplan Meier method was used to describe the survival curve and collect the data that may influence the prognosis. All the data of 31 factors were analyzed retrospectively using Cox regression model. Results The cumulative survival rates of the whole group at 0, 5, 1, 2 and 3 years were 57.1 %, 2 9.6 %, 14 .3 % and 6 .1 % respectively. The average survival time was 10.7 months. Univariate analysis of Cox regression model revealed that there were statistical differences in tumor diameters and a total of 19 prognostic factors, and multivariate analysis suggested that tumor diameter, diameter difference after treatment, number of interventions, portal vein cancer thrombosis, family per capita income, and quality of life There are significant statistical differences in the six items of improvement. Conclusions In addition to clinical factors such as tumor diameter before and after treatment, number of interventions, and portal vein cancer thrombosis, non-clinical factors such as the patient’s economic status and quality of life have a great influence on prognosis.