摘要
目的评价射频消融(RFA)治疗和射频消融联合无水酒精注射(RFA+PEI)治疗2种方式对原发性肝癌的治疗效果。方法采用Cox回归模型筛选影响肝癌患者生存时间的影响因素,利用logistic回归模型计算肝癌患者的倾向指数并按照倾向指数进行组间卡钳匹配,对匹配后的数据进行生存分析。结果 Cox逐步回归分析结果表明,肝癌患者生存时间的影响因素有Child分级、HBsAg携带情况、年龄、肿瘤疾病史、甲胎蛋白含量和治疗方式;匹配前,肝癌患者的年龄、Child分级、肿瘤疾病史、HBsAg携带情况及甲胎蛋白含量等因素在2组患者中分布不均衡,RFA组和RFA+PEI组的中位生存期分别为0.896和0.924年,1年生存率分别为43.9%和47.8%,2组患者的生存曲线差异无统计学意义(P>0.05);经卡钳匹配后,共有140对患者匹配成功,匹配率为52.7%,RFA组和RFA+PEI组的中位生存期分别为0.690和0.898年,1年生存率分别为32.7%和47.7%,2组患者生存曲线间差异有统计学意义(χ2=11.148,P=0.001)。结论 RFA+PEI治疗方式对肝癌的治疗效果优于RFA治疗;在肝癌的治疗效果评价中,组间卡钳匹配法可有效控制混杂因素。
Objective To evaluate the effectiveness of radiofrequency ablation（RFA） with or without percutaneous ethanal injection（PEI） in hepatocellular carcinoma（HCC） treatment.Methods The influencing factors of HCC patients’s survival time were screened with Cox regression model and every patient’s propensity score was calculated with logistic regression model and caliper matching was carried according to the propensity score;then survival analysis was performed with the matched data.Results The Cox regression results showed that Child grade,age,family history of tumor,hepatitis B virus surface antigen（HBsAg）,and alpha fetoprotein（AFP） affected patients’ survival time.Before matching,the factors had unbalanced distribution between two groups,and two survival curves had no statistically significant difference（P＆gt;0.05）.However,there was a statistically significant difference after matching（P＆lt;0.05）.Conclusion RFA combined with PEI for HCC treatment is more effective than simple RFA alone.The propensity score matching method can effectively reduce the confounding bias and make correct evaluation on therapeutic effect for HCC.
出处
《中国公共卫生》
CAS
CSCD
北大核心
2013年第7期982-984,共3页
Chinese Journal of Public Health
基金
国家自然科学基金(81141112)
山东省自然科学基金(ZR2009CM117)
关键词
卡钳匹配
倾向指数
原发性肝癌
疗效
生存分析
caliper matching
propensity score
primary hepatocellular carcinoma
curative effect
survival analysis
