摘要
目的:探讨术后辅助性经导管肝动脉化疗栓塞术(TACE)治疗对伴微血管侵犯肝癌患者远期预后的影响。方法:分别将是否伴微血管侵犯肝癌患者以术后是否行TACE治疗分为TACE组与N-TACE组,并且作为因变量,各临床病理指标作为自变量,采用倾向性评分匹配法进行匹配,Kaplan-Meier生存分析分别比较匹配后伴微血管侵犯和不伴微血管侵犯肝癌患者TACE组和N-TACE组术后无病生存率和总生存率,采用Cox回归分析评价辅助性TACE治疗对伴微血管侵犯肝癌患者术后无病生存时间和总生存时间的影响。结果:匹配后伴微血管侵犯和不伴微血管侵犯肝癌患者TACE组和N-TACE组的临床病理指标均衡性都得到了明显的提高,Kaplan-Meier生存分析显示,匹配后微血管侵犯肝癌患者TACE组术后1、3、5年无病生存率显著高于N-TACE组(94.6%、58.6%、41.8%与78.5%、37.2%、27.9%,P<0.05),TACE组术后1、3、5年总生存率显著高于N-TACE组(91.4%、77.4%、72.1%与70.9%、48.5%、51.4%,P<0.05),但非微血管侵犯肝癌患者TACE组和N-TACE组术后无病生存率和总生存率差异无统计学意义。Cox回归分析显示,辅助性TACE治疗显著延长了微血管侵犯肝癌患者术后无病生存时间和总生存时间。结论:术后辅助性TACE治疗能为伴微血管侵犯肝癌患者带来明显的生存获益。
Objective: To investigate the effect of postoperative adjuvant transcatheter arterial chemoembolization(TACE) on the long-term prognosis of hepatocellular carcinoma(HCC) patients with microvascular invasion(MVI). Methods: The HCC patients with MVI or not were divided into TACE group and N-TACE group according to whether or not to receive TACE treatment after operation, and as dependent variables, the clinical pathological indicators as independent variables. The propensity score matching was used for matching, Kaplan Meier survival analysis was used to compare the disease-free survival rate and overall survival rate between TACE group and N-TACE group with and without microvascular invasion. Cox regression analysis was used to evaluate the effect of adjuvant TACE on disease-free survival time and overall survival time of postoperative HCC patients with microvascular invasion. Results: After matching, the balance of clinicopathological parameters between TACE group and N-TACE group was significantly improved. Kaplan Meier survival analysis showed that the 1-year, 3-year and 5-year disease-free survival rate of postoperative HCC patients with microvascular invasion in TACE group was significantly higher than that in N-TACE group(94.6%, 58.6%, 41.8% vs 78.5%, 37.2%, 27.9%, P<0.05), the 1-year, 3-year and 5-year overall survival rates of TACE group were significantly higher than those of N-TACE group(91.4%, 77.4%, 72.1% vs 70.9%, 48.5%, 51.4%, P<0.05), but there was no significant difference in disease-free survival rate and overall survival rate of postoperative HCC patients without MVI between TACE group and N-TACE group. Cox regression analysis showed that adjuvant TACE treatment significantly prolonged disease-free survival and overall survival of postoperative HCC patients with microvascular invasion. Conclusion: Postoperative adjuvant TACE treatment can bring significant survival benefits for HCC patients with microvascular invasion.
作者
钟庆
郭熙清
ZHONG Qing;GUO Xiqing(Department of Hepatology,Three Gorges Hospital of Chongqing University,Chongqing,400100,China)
出处
《中国中西医结合消化杂志》
CAS
2021年第9期623-628,共6页
Chinese Journal of Integrated Traditional and Western Medicine on Digestion
关键词
倾向性匹配评分法
导管肝动脉化疗栓塞术
肝癌
微血管侵犯
预后
propensity matching score
transcatheter arterial chemoembolization
hepatocellular carcinoma
microvascular invasion
prognosis
作者简介
通信作者:钟庆,E-mail:bear78646169@163.com。
