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目的:探讨两种不同方案治疗直径小于10 cm肝细胞癌合并门静脉癌栓患者影响生存率。方法:将我院100例直径小于10cm肝细胞癌合并门静脉癌栓患者按照抽签法随机地均分为A、B两组,A组行单纯肝动脉插管化疗栓撒(TACE)治疗,B组肝癌手术切除联合癌栓切除+TACE术,比较两组患者治疗前后DLL4蛋白与VEGF蛋白阳性表达率、五年生存率以及影响患者生存率的因素。结果:(1)A组治疗前后DLL4蛋白与VEGF蛋白阳性表达率差异无统计学意义(P>0.05),B组治疗前后上述蛋白阳性表达率差异具有统计学意义(P<0.05,P<0.01);(2)根据Kaplan-Meir计算方法,B组五年生存率均明显大于A组(P<0.001);(3)经Pearson单因素与COX多因素分析,影响患者预后的危险独立因素为肿瘤大小与手术方式。结论:综合治疗方案用于治疗直径小于10cm肝细胞癌合并门静脉癌栓患者之中,疗效显著,患者五年生存率明显提高。
Objective: To investigate the effects of two different regimens on the survival rate of patients with hepatocellular carcinoma less than 10 cm in diameter and with portal vein tumor thrombus. Methods: One hundred patients with less than 10 cm hepatocellular carcinoma and portal vein tumor thrombus in our hospital were randomly divided into A and B groups according to the random selection method. A group received simple hepatic artery catheterization (TACE) and B group Hepatocellular carcinoma (HCC) resection combined with thrombectomy + TACE was performed to compare the positive expression rates of DLL4 protein and VEGF protein in two groups before and after treatment. The five-year survival rate and the factors influencing the survival rate of patients were compared. Results: (1) There was no significant difference in the expression rates of DLL4 protein and VEGF protein before and after treatment in group A (P> 0.05), but there was a significant difference between the two groups before and after treatment (P <0.05, P <0.01) ). (2) According to the Kaplan-Meir method, the five-year survival rates of group B were significantly higher than those of group A (P <0.001). (3) The risk independent factors influencing the prognosis of patients by single factor analysis of Pearson and COX Tumor size and surgical approach. Conclusion: The comprehensive treatment regimen is effective in treating patients with hepatocellular carcinoma less than 10 cm in diameter and with portal vein tumor thrombus, and the five-year survival rate of patients is significantly higher.