原发性肝癌伴门静脉癌栓的高危因素分析

发布时间：2018-04-14 12:16

本文选题：原发性肝癌 + 门静脉癌栓　；参考：《蚌埠医学院》2015年硕士论文

【摘要】：目的总结原发性肝癌合并门静脉癌栓的发生率,并探讨肝癌患者形成门静脉癌栓的相关因素,提高对PTVV的全面认识,为临床HCC伴PVTT的防治提供依据及达到更好疗效。方法回顾性分析我科2013年9月至2014年9月67例原发性肝癌患者的生化检查、临床表现、影像学资料和病历资料等,总结门静脉癌栓在肝癌患者中的发生率。根据影像学检查及手术探查结果,分为门静脉癌栓组22例,无门静脉癌栓组45例,单因素分析和多因素Logistic回归分析方法分析两组的年龄、性别、肿瘤的中心位置、有无肝硬化基础、有无乙肝、Child分级、腹水、门静脉高压、上消化道出血、ALT、AST、ALP、GGT、TBIL、ALB、AFP、PT、PLT等临床资料与PVTT形成的相关性,得出PVTT形成的相关危险因素。结果HCC患者伴PVTT形成者占32.8%,单因素分析提示门静脉癌栓形成与ALT、ALP、GGT、AFP、Child分级、腹水、门静脉高压、消化道出血有关,多因素Logistic回归分析提示ALP、GGT、AFP、腹水是肝癌伴门脉癌栓形成的危险因素。结论原发性肝癌患者伴门静脉癌栓形成的发生率高。血清ALP、GGT、AFP升高并形成腹水的患者容易诱发形成门静脉癌栓,为原发性肝癌患者形成门脉癌栓的独立危险因素。
[Abstract]:Objective to summarize the incidence of primary liver cancer complicated with portal vein tumor thrombus, and to explore the related factors of portal vein tumor thrombus formation in patients with primary liver cancer, to improve the overall understanding of PTVV, and to provide evidence for the prevention and treatment of HCC with PVTT and to achieve better curative effect.Methods from September 2013 to September 2014, 67 patients with primary liver cancer were retrospectively analyzed for their biochemical examination, clinical manifestations, imaging data and medical records, and the incidence of portal vein tumor thrombus in patients with liver cancer was summarized.According to the results of imaging examination and surgical exploration, the patients were divided into two groups: the portal vein tumor thrombus group (n = 22) and the non-portal vein tumor thrombus group (n = 45). The age, sex and central location of the tumor were analyzed by univariate analysis and multivariate Logistic regression analysis.The correlation between the clinical data and the formation of PVTT was found, such as the basis of cirrhosis, the classification of hepatitis B, ascites, portal hypertension, upper gastrointestinal hemorrhage, ALTAST, TBILT, ALB, AFP, PTPLT, and so on. The risk factors related to the formation of PVTT were obtained.Results the incidence of PVTT in patients with HCC was 32.8%. Univariate analysis showed that the formation of portal vein tumor thrombus was related to the grade of AFP Child, ascites, portal hypertension and gastrointestinal bleeding. The multivariate Logistic regression analysis suggested that the ascites were the risk factors for the formation of hepatic carcinoma with portal vein tumor thrombus.Conclusion the incidence of portal vein thrombosis in patients with primary liver cancer is high.Patients with elevated serum ALP GGT AFP and ascites were prone to develop portal vein tumor thrombus, which was an independent risk factor for portal vein tumor thrombus in patients with primary liver cancer.
【学位授予单位】：蚌埠医学院
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R735.7

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