乙型肝炎相关性中晚期原发性肝癌预后影响因素分析.docVIP

精品论文 参考文献 乙型肝炎相关性中晚期原发性肝癌预后影响因素分析 1 南华大学附属郴州市第一人民医院 湖南郴州 423000；2 郴州市第一人民医院消化疾病诊疗中心 湖南郴州 423000 【摘 要】目的：探讨乙肝表面抗原阳性的原发性肝癌预后影响因素。方法：回顾性分析我院2010年1月至2013年12月收治的95例表面抗原阳性的原发性肝癌患者，建立病例资料数据库，应用Kaplan-Meier方法计算生存期，对相关因素采用Log-rank检验进行生存率的单因素分析以及Cox风险比例模型进行多因素分析筛选出独立预后因素。结果：本组患者中位生存时间为10个月，1、2、3、5 年累积生存率分别为 39.0％、17.9％、8.40％、1.05％。Cox 逐步回归多因素分析与预后有关并具有显著意义的因素变量为AFP、远处器官转移、肝癌巴塞罗那分期、门静脉癌栓、治疗方法、TACE治疗次数及抗病毒治疗。结论：AFP、远处器官转移、肝癌巴塞罗那分期及门静脉癌栓是表面抗原阳性原发性肝癌患者预后的危险因素，抗病毒治疗、TACE治疗及适当重复TACE治疗能延迟患者生存期。 【关键字】乙型肝炎；原发性肝癌；病毒载量；抗病毒治疗；预后影响因素 Analysis of prognostic factors in hepatitis B-associated advanced primary liver cancer Wu Guangxin1，Guo Fengfan1，Zou Dianrong1，Zhong Yueyuan1，Ou Wensheng2 （1 Nanhua University Affiliated First People＇s Hospital of Chenzhou City，Chenzhou，Hunan 423000，China；2 Digestive disease diagnosis and treatment center of Chenzhou No．1 Peoples Hospital Chenzhou，Hunan 423000，China） 【Abstract】：Objective：To explore the prognostic factors in advanced primary hepatocarcinoma patients with hepatitis B surface antigen positive.Methods：A total of 95 cases with complete data were selected from January 2010to December 2013 in Chenzhou Affiliated Hospital of the University of South China.Single-factor analysis and multivariate analysis was performed on prognostic factors using Kaplan-Meier，Log-rank and Cox regression analysis by SPSS software version 11..Results：The median survival time was 10 months and the 1-，2-，3- and 5-year overall survival rates was 39.0％，17.9％，8.40％，and 1.05％，respectively.Prognostic factors in multivariate analysis were AFP、the distant organ metastasis、BCLC class，portal vein tumor thrombus，therapeutic method，frequency of TACE treatment and antiviral therapy were the relative factors.Conclusion：AFP、the distant organ metastasis、BCLC class，portal vein tumor thrombus are the risk prognostic factors，and antiviral therapy，TACE and appropriate retreatment of TACE can prolong the overall survival time. 【Key words】：hepatitis B viru