影响原发性肝癌治疗预后的相关因素分析【荐】.docVIP

影响原发性肝癌治疗预后的相关因素分析 　　作者：夏国华 　滨州医学院附属医院肝胆外科 滨州市 256603 　　【摘要】 目的 通过对原发性肝癌患者临床疗效和预后的分析，探讨影响原发性肝癌治疗预后的相关因素，以期为临床综合治疗和预后判断提供理论依据。方法 回顾性分析我院2002年1月―2005年12月收治的260例原发性肝癌患者的病历及随访资料，采用Cox回归(比例风险模型)方法对可能影响疗效和预后的16项临床相关因素进行单、多因素综合定量分析。结果 单因素分析显示与预后明显相关的因素为治疗方式、肿瘤大小、肿瘤数目、肝功能、肝硬化、远处转移和血管癌栓;多因素分析显示的因素为治疗方式、肿瘤大小、肿瘤数目、肝功能和血管癌栓。结论 原发性肝癌的预后取决于治疗方式、肿瘤大小、肿瘤数目、肝功能等方面，了解影响预后的因素对临床上选择和治疗病人有重要的实用价值。 　　【关键词】 原发性肝癌;预后因素; Cox回归分析 　　Analysis of related factors affecting prognosis for primary liver cancer 　　XIA Guohua 　　Department of Hepatobiliary Surgery, Affiliated Hospital of Binzhou Medical College, Binzhou 256603 　　【Abstract】 Objective Through analyzing clinical prognosis of patients with primary liver cancer (PLC) and discussing prognostic factors affecting longterm outcome, so as to provide theoretic evidence in the comprehensive treatment and prognostic judgment of PLC.Methods A retrospective analysis of clinical and followup data of 260 patients with PLC in our hospital from January 2002 to December 2005. Sixteen possible factors with longterm survival rate were analyzed in Cox regression (proportional hazard model). Results Univariate analysis showed that treatment pattern, tumor size, tumor nodule number, liver function, liver cirrhosis, distal metastasis and tumor embolus in vein were significant prognostic factors. The multivariate analysis by Cox regression, the independent prognostic factors were treatment pattern, tumor size, tumor nodule number, liver function and tumor embolus in vein.Conclusion The prognosis of PLC was focused on the following aspects: treatment pattern, tumor size, tumor nodule number, liver function. Knowledge of the factors affecting prognosis is helpful for the selection and management of patients. 　　【Key words】 primary liver cancer，prognostic factors，Cox regression analysis 　　原发性肝癌(primary liver cancer，PLC)是我国常见的恶性肿瘤，亦是世界上十种最常见的恶性肿瘤之一。据卫生部的统计资料，我国每年肝癌新发病例约为14万人，其中死亡约为11万人，年死亡率已增高到1995年的20.40/10万人，约占全世界发病人数和死亡人数的45%~50%。国