肝细胞癌患者伴发糖尿病行肝动脉化疗栓塞术的预后因素分析

发布时间：2018-02-14 21:56

本文关键词： 肝细胞癌肝动脉栓塞化疗糖尿病预后　出处：《介入放射学杂志》2017年10期 　论文类型：期刊论文

【摘要】：目的分析糖尿病(DM)对不可切除肝细胞癌(HCC)患者TACE术后预后的影响。方法选取2010年1月-2015年6月就诊于上海交通大学医学院附属新华医院行TACE术的HCC患者858例,其中合并DM患者175例(DM组),HCC未合并DM患者683例(非DM组),分析两组患者一般临床资料及总体生存的差异。生存率用Kaplan-Meier法计算,组间差异采用Log-Rank方法,采用Cox比例风险回归分析不可切除HCC患者TACE术预后的影响因素。结果两组性别、年龄、血清总胆红素、白蛋白、凝血酶原时间、甲胎蛋白(AFP)、Child-Pugh分级、肿瘤最大直径和数目、肝硬化、TACE治疗次数以及BCLC分期比较,差异均无统计学意义(P0.05);DM组空腹血糖(FPG)水平高于非DM组(P0.05)。DM组患者1、3、5年生存率为60.9%、27.5%和10.7%,非DM组为70.9%、36.0%和17.6%,经Log-rank检验,差异存在统计学意义(P=0.008)。将上述变量进行多因素Cox比例风险回归分析结果显示,肿瘤最大直径5 cm、肿瘤数目多发、AFP20 ng/ml、BCLC分期、以及合并DM是影响HCC患者TACE预后的独立危险因素。结论 DM是影响不可切除HCC患者TACE后独立危险因素。
[Abstract]:Objective to analyze the effect of diabetes mellitus (DM) on the prognosis of patients with unresectable hepatocellular carcinoma (HCC) after TACE. Methods from January 2010 to June 2015, 858 patients with HCC underwent TACE operation at Xinhua Hospital affiliated to Shanghai Jiaotong University Medical College. There were 175 patients with DM and 683 patients with HCC without DM (non-DM group). The general clinical data and the overall survival of the two groups were analyzed. The survival rate was calculated by Kaplan-Meier method, and the difference between the two groups was calculated by Log-Rank method. Results Sex, age, serum total bilirubin, albumin, prothrombin time, alpha-fetoprotein and Child-Pugh grade, maximum diameter and number of tumors were determined by Cox proportional risk regression analysis in patients with unresectable HCC. There was no significant difference in the frequency of TACE treatment and the BCLC staging. The level of fasting blood glucose in DM group was significantly higher than that in non-DM group. The 5-year survival rate was 27.5% and 10.7%, and the 5-year survival rate was 70.9% and 17.6% in non-DM group. Log-rank test was performed. The results of multivariate Cox proportional risk regression analysis showed that the maximum diameter of tumor was 5 cm, the number of tumors was multiple, and AFP 20 ng / ml / ml was used to stage BCLC. Conclusion DM is an independent risk factor after TACE in patients with unresectable HCC.
【作者单位】：上海交通大学医学院附属新华医院放射介入科;上海交通大学医学院附属新华医院放射科;
【分类号】：R587.1;R735.7

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