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目的研究肝动脉化疗栓塞(TACE)治疗直径<5cm肝癌的效果以及预后因素。方法对1995年2月-2004年2月间肝动脉化疗栓塞治疗的直径<5cm的原发性肝癌患者160例的效果进行回顾性分析,log-rank方法单因素分析影响预后的因素,多因素分析采用Cox比例风险模型确定独立的危险因素。结果肝动脉化疗栓塞后的1年、3年、5年生存率分别为77.52%、47.42%、33.68%。血清胆红素水平>17.0μmol/L、凝血酶原时间超过14s、有门静脉癌栓和有远处转移是影响预后的独立的危险因素。结论对于手术不能切除的直径<5cm的肝癌,肝动脉化疗栓塞是可供选择的有效治疗方法,但有血清胆红素升高或凝血酶原延长的病人,或有门静脉癌栓和远处转移的病人,预后较差。
Objective To investigate the effect and prognostic factor of transcatheter arterial chemoembolization (TACE) in the treatment of hepatic carcinoma of diameter <5cm. Methods A retrospective analysis was performed on the effect of 160 cases of primary liver cancer with diameter <5cm between February 1995 and February 2004. Log-rank method was used to analyze the prognostic factors, Analysis Cox proportional hazards model was used to identify independent risk factors. Results The 1-year, 3-year and 5-year survival rates after hepatic artery chemoembolization were 77.52%, 47.42% and 33.68%, respectively. Serum bilirubin levels> 17.0μmol / L, prothrombin time over 14s, with portal vein tumor thrombus and distant metastasis are independent risk factors affecting the prognosis. CONCLUSIONS: Transcatheter arterial chemoembolization is an effective and effective alternative for the treatment of unresectable hepatocellular carcinoma with a diameter less than 5 cm. However, patients with elevated serum bilirubin or prolonged prothrombin or portal vein tumor thrombus and distant metastasis Of patients, the prognosis is poor.