摘要
旨在分析行肝动脉灌注药物（ＴＡＩ）和栓塞（ＴＡＥ）治疗的原发性肝癌的预后因素，对适应证再评价，并提出一种科学简便的预测预后的方法。分别用单因素和多因素方法对９２例行介入治疗的原发性肝癌进行了回顾性统计分析。其中行单纯灌注药物（ＴＡＩ）者２７人；碘化油化疗栓塞（ＬｐＴＡＣＥ）者１９人；碘化油加明胶海绵化疗栓塞（ＬｐＧｓＴＡＣＥ）者４６人。结果：单因素分析从１９个变量中得出肿瘤类型、包膜、门脉瘤栓、Ｃｈｉｌｄｓ分级、Ｏｋｕｄａｓ分期、治疗方式６个因素是影响ＴＡＩ和ＴＡＥ治疗预后的显著因素。用Ｃｏｘ比例风险模型多因素分析显示仅有Ｏｋｕｄａｓ分期和治疗方式是影响预后的独立的重要因素。根据Ｃｏｘ最终模型方程，得到预后指数：ＰＩ＝０．００１３×Ｏｋｕｄａｓ分期－０．２４９６×治疗方式，当病人ＰＩ＜－０．５为预后良好，ＰＩ＞－０．５为预后差。结论：肝癌体积过大，无包膜，合并有门脉瘤栓，肝功能明显减损，进行ＴＡＩ或ＴＡＥ时要慎重。通过评价病人Ｏｋｕｄａｓ分期，结合治疗方式计算预后指数（ＰＩ），可以预测预后，试用于临床，起到选择病例。
From Feb1992 to Sept1995,92 patients with primary hepatic carcinoma (PHC) were treated with transcatheter arterial infusion chemotherapy (TAI) and embolization (TAE). Twentyseven patients underwent TAI and 19 patients recieved chemotherapy and lipiodol embolization (TAI-LP+TAE).The remaining 46 patients recieved chemotherapy, lipiodol and gelfoam embolization(TAI+LP+GS-TAE). Results: Based on single factor analysis those factors that affected survival out of the 19 variables were tumor size, encapsulation, portal thrombosis, Childs grading, Okudas staging and therapeutic modality. A multivariateanalysis was performed using Coxs proportional hazard model.Okudas staging and therapeutic modality were the only two factors that bore independent prognostic significance. Regression equation was used to describe a prognostic index (PI), where PI=0.0013 × Okuda stage0.2496 × therapeutic modality.In accordance with the prognostic index,these patients were divided into two groups,i.e. those with good prognosis (PI<0.5), and those with poor(P>0.5).This study demonstrated that PI can be used not only for predicting the survival time of a given group of patients with PHC, but also for selecting patients for TAI and TAE therapy.
出处
《中国肿瘤临床》
CAS
CSCD
北大核心
1998年第4期248-251,共4页
Chinese Journal of Clinical Oncology
关键词
肝肿瘤
预后
多因素分析
栓塞治疗
Primary hepatic cancer Transcatheter arterial infusion Transcatheter arterial embolization Prognostic factor Multivariate analysis
