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肝癌分期对肝动脉化疗栓塞术后生存的预测作用
Prognostic accuracy of staging systems in patients with primary liver cancer treated with transarterial chemoembolization
文章发布日期:2011年03月16日  来源:  作者:张 峰 诸葛宇征 仇毓东等  点击次数:5100次  下载次数:1442次

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【摘要】:目的 探索肝癌肝动脉化疗栓塞术(TACE)术后患者预后评价的有效分期。方法 回顾性分析2006年9月至2009年5月间行 TACE治疗的原发性肝癌患者的临床随访资料,比较CTP分级、MELD评分、Okuda分期、BCLC分级、CS分期和Tokyo评分对TACE 治疗后生存情况的预测能力的差异。结果 Kaplan-Meier生存曲线及log-rank检验结果显示,Okuda分期各期别间差异均有统计学 意义(ⅠvsⅡ P=0.013,ⅡvsⅢ P<0.001);BCLC分级B级与C级间差异有统计学意义(P=0.008);CS分期Ⅱ期同Ⅲ期之间差异具有统 计学意义(P=0.001)。Cox多因素回归分析得到Okuda分期(P=0.039)、BCLC分级(P=0.022)有统计学意义。BCLC分级同时具有最小 的-2Ln(L)、AIC、SBC值,分别为205.419、209.419、212.586。结论 BCLC分级对TACE治疗后的生存情况具有较好的预测作用, 可能有助于选择适宜行TACE治疗的患者。
【Abstract】:Objective To compare the performance of 6 available prognostic staging systems in predicting the survival of patients with primary liver cancer treated with TACE. Methods The clinical data of patients who had been diagnosed as liver cancer in our department from September 2006 to May 2009 were retrospectively analyzed to compare the CTP classification, the MELD scoring, the BCLC classification system, the CS staging system and the Tokyo scoring. Results The survival curves and log-rank test shows statistical significance in all stages of the Okuda staging system(Ⅰvs Ⅱ P=0.013, Ⅱvs Ⅲ P<0.001), between stage B and C of the BCLC classification system (P=0.008) and between stage II and III of the CS staging system (P=0.001). By the multiple factor regression method, the Okuda staging system (P=0.039) and the BCLC classification (P=0.022) also show a stronger significance on the prognosis. And the BCLC classification system is superior to the other staging systems with the minimum value of -2Ln(L) ( 205.419), AIC (209.419), SBC (212.586). Conclusion The BCLC classification system provides the best prognostic stratification for a cohort of the patients with liver cancer treated with transarterial chemoembolization.
【关键字】:肝肿瘤;肝动脉;化学栓塞,治疗性
【Key words】:Objective To compare the performance of 6 available prognostic staging systems in predicting the survival of patients
【引证本文】:

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