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目的探讨肿瘤切除术前行经皮股动脉穿刺肝动脉化疗栓塞术(TACE)对巴塞罗那临床肝癌(BCLC)分期B期患者预后的影响。方法对309例首次行肝癌切除术的BCLC分期B期患者的临床资料进行回顾性分析,根据术前是否行TACE分为联合组和手术组,用两独立样本t检验和Pearsonχ2检验比较两组一般临床资料,用Log-rank检验和Cox比例风险回归模型比较两组生存率。结果两组一般临床资料无统计学差异(P>0.05);联合组和手术组中位生存期分别为36、26个月,组间比较P<0.05(χ2=9.226);治疗方式、肿瘤直径、手术切缘和血清AFP水平是影响患者生存率的危险因素(P<0.05),且治疗方式是影响患者预后的独立危险因素(RR为1.576,95%CI为1.157~2.146,P=0.004)。结论对于BCLC分期B期患者,在切除术前给予辅助性TACE治疗有望延长术后生存时间。
Objective To investigate the effect of percutaneous transhepatic arterial chemoembolization (TACE) on the prognosis of stage B patients with clinical liver cancer (BCLC) in Barcelona before tumor resection. Methods The clinical data of 309 patients with BCLC stage B who underwent primary resection of liver cancer were retrospectively analyzed. TACE was divided into combined group and operation group according to whether TACE was performed preoperatively. Two independent samples t test and Pearsonχ2 test were used to compare the two groups Clinical data, using Log-rank test and Cox proportional hazards regression model to compare the two groups survival rate. Results There was no significant difference between the two groups (P> 0.05). The median survival time was 36 and 26 months in the combined group and the operation group, respectively, P <0.05 (χ2 = 9.226) , Surgical margin and serum AFP level were risk factors influencing survival rate (P <0.05), and the treatment was an independent risk factor affecting the prognosis of patients (RR 1.576, 95% CI 1.157 ~ 2.146, P 0.004) . Conclusion For patients with BCLC stage B, adjuvant TACE before resection is expected to prolong postoperative survival.