| 杨薇,陈敏华,严昆,高文,王艳滨,廖盛日,张晖,霍苓,黄信孚.肝细胞癌射频治疗总生存率及无瘤生存率探讨[J].中国医学影像技术,2006,22(1):121~124 |
| 肝细胞癌射频治疗总生存率及无瘤生存率探讨 |
| Overall survival and disease-free survival of radiofrequency ablation of hepatocellular carcinoma |
| 投稿时间：2005-08-24 修订日期：2005-10-27 |
| DOI： |
| 中文关键词: 肝细胞癌 射频消融 生存分析 COX模型 |
| 英文关键词:Hepatocellular carcinoma Radiof requency ablation Prognostic factor COX regression model |
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| 中文摘要: |
| 目的 探讨肝细胞癌( HCC) 射频消融(RFA) 治疗后的总生存率和无瘤生存率的影响因素。方法 182 例HCC患者行超声引导下RFA 治疗。肿瘤平均大小(3. 9 ±1. 2) cm(范围1. 2～8. 0 cm) 。肝功能Child2Pugh 分级A、B、C 级分别为97 、76 和9 例。根据TNM 分期,Ⅰ- Ⅱ期, Ⅲ期, Ⅳ期肝癌分别为53 、70 和59 例。筛选22 项可能对预后产生影响的临床因素并分层,单因素分析采用Kaplain2Meier 模型,多因素采用COX 比例风险模型。结果 182 例HCC 治疗后平均总生存期及无瘤生存期分别为(45. 5 ±2. 3) 和(24. 9 ±2. 1) 个月。生存期的影响因素为: ①总生存期: 卫星灶,Child2Pugh 分级和TNM 分期。②无瘤生存期: 肿瘤数目,卫星灶,Child2Pugh 分级,按规范化方案治疗,联合TACE。其中,肝功能在两种生存率分析中均为危险度最高的影响因素。结论 生存分析结果提示,保护肝功能,治疗前全面影像学检查,重视规范化治疗和辅助治疗将有助于改善生存期。 |
| 英文摘要: |
| Objective To investigate the prognostic factors affecting overall survival and f ree2disease survival in radiof re-quency ablation (RFA) of hepatocellular carcinoma ( HCC) . Methods A total of 182 HCC patient s underwent RFA t reat-ment in our department and were enrolled into this study. The average tumor size was (3. 9 ±1. 2) cm ( range 1.2 - 8. 0 cm) .Ninety-seven of the 182 HCC patient s had Child2Pugh class cirrhosis A ; 76 , class B ; and 9 , class C. According to TNM system , 53 patient s were at stage Ⅰ- Ⅱ, 70 at stage Ⅲand 59 at stage Ⅳ, respectively. A total of 22 factors , which po-tentially affected the outcome , were analyzed. Kaplan2Meier model and log2rank test were used in univariate analysis and COX regression model was used in multivariate analyses , to identify prognostic factors for survival. Results The mean over-all survival and disease2f ree survival were (45. 5 ±2. 3) months and (24. 9 ±2. 1) months , respectively. The significant fac-tors in univariate analysis were further analyzed by multivariate model and the following factors were identified as prognostic factor for survival. ①Overall survival : daughter lesion , Child2Pugh classification , TNM stage. ②Disease-f ree survival:tumor number , daughter lesion , Child2Pugh classification , standard t reatment protocol , combination with TACE. Among these , Child2Pugh classification was the most risk factors for two kinds of survivals. Conclusion Based on our statistical a-nalysis , careful imaging examination , protection of liver function and application of proper t reatment st rategy and adjuvant therapy might benefit the survival. |
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