本文關(guān)鍵詞： 肝細(xì)胞癌 肝動(dòng)脈栓塞化療 糖尿病 預(yù)后　出處：《介入放射學(xué)雜志》2017年10期 　論文類型：期刊論文

【摘要】：目的分析糖尿病(DM)對不可切除肝細(xì)胞癌(HCC)患者TACE術(shù)后預(yù)后的影響。方法選取2010年1月-2015年6月就診于上海交通大學(xué)醫(yī)學(xué)院附屬新華醫(yī)院行TACE術(shù)的HCC患者858例,其中合并DM患者175例(DM組),HCC未合并DM患者683例(非DM組),分析兩組患者一般臨床資料及總體生存的差異。生存率用Kaplan-Meier法計(jì)算,組間差異采用Log-Rank方法,采用Cox比例風(fēng)險(xiǎn)回歸分析不可切除HCC患者TACE術(shù)預(yù)后的影響因素。結(jié)果兩組性別、年齡、血清總膽紅素、白蛋白、凝血酶原時(shí)間、甲胎蛋白(AFP)、Child-Pugh分級、腫瘤最大直徑和數(shù)目、肝硬化、TACE治療次數(shù)以及BCLC分期比較,差異均無統(tǒng)計(jì)學(xué)意義(P0.05);DM組空腹血糖(FPG)水平高于非DM組(P0.05)。DM組患者1、3、5年生存率為60.9%、27.5%和10.7%,非DM組為70.9%、36.0%和17.6%,經(jīng)Log-rank檢驗(yàn),差異存在統(tǒng)計(jì)學(xué)意義(P=0.008)。將上述變量進(jìn)行多因素Cox比例風(fēng)險(xiǎn)回歸分析結(jié)果顯示,腫瘤最大直徑5 cm、腫瘤數(shù)目多發(fā)、AFP20 ng/ml、BCLC分期、以及合并DM是影響HCC患者TACE預(yù)后的獨(dú)立危險(xiǎn)因素。結(jié)論 DM是影響不可切除HCC患者TACE后獨(dú)立危險(xiǎn)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.
【作者單位】： 上海交通大學(xué)醫(yī)學(xué)院附屬新華醫(yī)院放射介入科;上海交通大學(xué)醫(yī)學(xué)院附屬新華醫(yī)院放射科;
【分類號】：R587.1;R735.7

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