不同微创治疗方法对HBV相关原发性肝癌合并门静脉癌栓患者的预后影响

李梦阁; 赵亚林; 刘晓利; 王欣慧; 江宇泳; 杨志云

doi:10.3969/j.issn.1001-5256.2017.04.017

不同微创治疗方法对HBV相关原发性肝癌合并门静脉癌栓患者的预后影响

DOI: 10.3969/j.issn.1001-5256.2017.04.017

1. 首都医科大学附属北京地坛医院中西医结合中心
2. 北京中医药大学东直门医院

基金项目:

首都卫生发展科研专项基金资助项目(2016-2-2171)；北京市教委科技计划基金资助项目(SQKM201610025026)；北京卫生系统高层次人才培养基金资助项目(2013-3-026)；

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中图分类号: R735.7
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出版历程
- 出版日期: 2017-04-20

Effect of different minimally invasive therapies on the prognosis of patients with HBV-related primary liver cancer complicated by portal vein tumor thrombus

Center for Combined TCM and Western Medicine, Beijing Ditan Hospital, Capital Medical University

Research funding:

摘要

摘要: 目的分析微创治疗对HBV相关原发性肝癌（PHC）合并门静脉癌栓（PVTT）的患者1年生存的影响,以指导临床治疗。方法收集首都医科大学附属北京地坛医院从2012年1月-2014年12月诊断为HBV相关PHC合并PVTT的患者,经筛选符合纳排标准的共191例。对患者进行随访,观察患者存活时间,将其分为生存组和死亡组,采集患者的人口学特征及相关临床指标信息。计量资料组间比较采用t检验或Mann-Whitney U检验;计数资料组间比较采用χ2检验。多因素分析采用Cox回归模型分析。结果 6个月内存活的患者共80例,接受微创治疗的52例（65%）,1年内存活的共57例,接受微创治疗的36例（63.16%）。微创治疗与否对HBV相关PHC合并PVTT患者6个月生存率有影响,差异有统计学意义（χ2=5.419,P=0.009）;对其1年生存率无影响（χ2=1.881,P=0.093）,但对其生存时间有影响,结果有统计学意义（P=0.001）。Cox多因素分析得出DBil和GGT为HBV相关PHC合并PVTT 1年生存的危险因素,微创...
- 肝肿瘤 /
- 门静脉癌栓 /
- 治疗 /
- 预后
Abstract: Objective To investigate the effect of minimally invasive therapy on the 1-year survival of patients with HBV-related primary liver cancer ( PLC) complicated by portal vein tumor thrombus ( PVTT) , and to provide a guidance for clinical treatment. Methods A total of 191 patients who were diagnosed with HBV-related PLC complicated by PVTT in Beijing Ditan Hospital, Capital Medical University, from January 2012 to December 2014 and met the inclusion criteria were enrolled. The patients were followed up to observe their survival time, and they were divided into survival group and death group. The demographic features and related clinical indices were collected. The t-test was used for comparison of normally distributed continuous data between groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups; the chi-square test was used for comparison of categorical data between groups. The Cox regression model was used for multivariate analysis. Results Of all patients, 80 achieved a 6-month survival time, among whom 52 ( 65%) underwent minimally invasive therapy, and 57 achieved a 1-year survival time, among whom 36 ( 63. 16%) underwent minimally invasive therapy. In patients with HBV-related PLC complicated by PVTT, minimally invasive therapy had a significant effect on the 6-month survival rate ( χ2= 5. 419, P = 0. 009) and had no significant effect on the 1-year survival rate ( χ2= 1. 881, P = 0.093) , with a significant effect on survival time ( P = 0. 001) . The Cox multivariate analysis showed that direct bilirubin and gamma-glutamyl transpeptidase were risk factors for 1-year survival in patients with HBV-related PLC complicated by PVTT, while minimally invasive therapy was a protective factor for 1-year survival ( RR = 0. 812, 1. 007, and 1. 002, P < 0. 001, P = 0. 002, and P = 0. 017) . Conclusion Radiofrequency ablation combined with transcatheter arterial chemoembolization should be performed as early as possible for patients with HBV-related PLC complicated by PVTT and can prolong survival time.
- liver neoplasms /
- portalvein tumor thrombus /
- therapy /
- prognosis

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