肝癌射频消融治疗后局部肿瘤进展影响分析.docVIP

肝癌射频消融治疗后局部肿瘤进展影响分析 　　[摘要] 目的 探讨肝癌射频消融治疗后出现局部肿瘤进展的危险因素。方法 方便选取2010年10月―2016年4月福建省肿瘤医院76例CT引导射频消融治疗后的肝癌患者，54例单纯接受RFA治疗， 22例行RFA前接受1～2次TACE治疗。对比分析两组患者RFA后TTP及发生局部肿瘤进展的独立危险因素。结果 RFA组均值TTP??26.38（20.02～32.75）个月；TACE序贯RFA组均值TTP为72.23（61.38～85.09）个月。肿瘤直径3 cm均值TTP为69.483（58.55～80.42）个月；肿瘤直径3～5 cm均值TTP为18.14（14.05～22.22）个月。经Log-rank检验，RFA组与TACE序贯RFA组TTP的差异有统计学意义（P=0.020）；肿瘤直径3 cm与3～5 cm的TTP的差异有统计学意义（P=0.040）。治疗方式（RFA组/TACE序贯RFA组）（HR=2.713，P=0.027）、肿瘤大小（3 cm/3～5 cm）（HR=2.748，P=0.043）是影响肝癌RFA后发生局部肿瘤进展的独立危险因素。结论 RFA治疗前行TACE治疗可降低术后局部肿瘤进展发生，肝癌瘤灶越大RFA后越容易发生局部肿瘤进展。 　　[关键词] 肝癌；射频消融；肝动脉化疗栓塞；局部肿瘤进展 　　[中图分类号] R735 [文献标识码] A [文章编号] 1674-0742（2017）12（a）-0001-04 　　[Abstract] Objective To study the risk factors of local tumor progress after the radiofrequency ablation therapy. Methods 76 cases of liver cancer patients after CT-guided radiofrequency ablation therapy in our hospital from October 2010 to April 2016 were convenient selected， including 54 cases with simple RFA therapy， and 22 cases with TACE therapy for 1 to 2 times before RFA， and TTP and independent risk factors of local tumor progress of the two groups after RFA were compared and analyzed. Results The average value of TTP in the RFA group was 26.38（20.02～32.75）months， and the average value of TACE sequence RFA group was 72.23（61.38～85.09）months， and the average value TTP of tumor diameter 3 cm was 69.483（58.55～80.42）months， and the average value TTP of tumor diameter between 3 cm and 5 cm was 18.14（14.05～22.22）months， and the Log-rank test showed that the difference in the TTP between the RFA group and the TACE sequence RFA group was statistically significant（P=0.020）， and the difference in the TTP between the tumor diameter 3 cm and tumor diameter between 3 cm and 5 cm was statistically significant（P=0.040）， and the treatment method （RFA group/TACE sequence RFA group） （HR=2.713，P=0.027）， tumor size （3 cm/3～5 cm）（HR=2.748，P=0.043）were the independent risk factors of local tumor progress of liver cancer RFA. Conclusio