原发性肝癌首次TACE治疗时RIPA参与肿瘤供血的影响因素分析.docVIP

DOI：10.16016/j.1000-5404.201502002 原发性肝癌首次TACE治疗时RIPA参与肿瘤供血的影响因素分析 罗家敏，罗小平，刘 曦，何明菊，杨 伟（重庆医科大学附属第二医院放射科，重庆400010） [摘要] 目的 分析原发性肝癌首次经动脉插管化疗栓塞时右侧膈下动脉（right inferior phrenic artery，RIPA）参与肿瘤供血的相关影响因素，作为术前判断其是否存在供血的重要参考依据。方法 回顾性分析我院161例原发性肝癌首次行插管化疗栓塞时即行右侧膈下动脉造影者的MRI或CT、DSA资料，按肿瘤是否有RIPA参与供血分RIPA组与NRIPA组，分析两组病例肿瘤大小、位置、包膜，并对其行单因素分析及多因素logistic回归分析。结果 161例中RIPA参与肿瘤供血77例(47.8%),单因素分析显示肿瘤大小(P 0.01)、是否累及肝包膜 ( P =0.034)、肿瘤有无完整包膜(P 0.01)、肿瘤主要部分所在肝段(P 0.01)在两组间有统计学差异，多因素logistic回归分析显示肿瘤大小分类、有无完整包膜及肿瘤主要部分所在肝段为首次TACE治疗时RIPA参与肿瘤供血的独立预测因素。结论 原发性肝癌首次TACE治疗时，当肿瘤为位于肝裸区或膈下的大肝癌，尤其是位于VII段且无完整包膜者，RIPA参与肿瘤供血的机会增加。 [关键词] 原发性肝癌；经动脉插管化疗栓塞；右侧膈下动脉；肿瘤血供；影响因素 [中图法分类号］ R735.7；R453.9；R322.1+21 ［文献标志码］ A Analysis about causative factors of RIPA participating in the blood supply of PLC at initial TACE session Luo Jiamin,Luo Xiaoping,Liu Xi,He Mingju，Yang Wei (Department of Radiology, Second Affiliated Hospital,Chongqing Medical University,Chongqing, 400010,China) [Abstract] Objective Analyze the causative factors of RIPA participating in the blood supply of PLC at initial TACE session, so as to provide important reference for judging whether there is blood supply from RIPA before TACE. Methods Retrospectively analyze the radiographic materials of 161 patients with PLC who underwent RIPA angiography at the first TACE treatment in our hospital, we divided all patients into RIPA group and NRIPA group according to whether RIPA participates in tumor blood supply or not. Evaluate tumor size,location and tumor capsule between the two groups,Univariate and multivariate analyses were performed in this study. Results 77 cases(47.8%) were founded to have the blood supply from RIPA at initial TACE session, Univariate analysis showed that tumor size ( P 0.01), involving the liver capsule ( P =0.034), tumor capsule (P 0.01) and tumor’s liver segment (P 0.01) were significantly associated with the blood supply from RIPA in PLC at initial TACE session,Multiple logistic regression analysis showed that the c