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目的探讨原发性肝癌患者肝动脉化疗栓塞(TACE)和肺转移间的关系。方法对287例原发性肝癌患者进行随防,其中行TACE治疗者102例,行保守治疗的对照组有185例,对肺转移患者行胸片和CT扫描检查。结果 TACE组的中位生存时间是19.3个月,而对照组为10个月。TACE组有14例发生肺转移,对照组有14例发生肺转移,两组间差异无统计学意义。单因素分析示肿瘤大小、异常的转氨酶水平和超声回声与肺转移有关。多因素分析显示,肿瘤大小是肺转移唯一有意义的因素。结论介入栓塞化疗对于延长肝癌患者生存期是有效的,但并不能降低肝癌肺转移的机率。肿瘤大小是肺转移与否唯一的预测因素。
Objective To investigate the relationship between transcatheter arterial chemoembolization (TACE) and lung metastasis in patients with primary liver cancer. Methods A total of 287 patients with primary liver cancer were enrolled in the study. Among them, 102 patients underwent TACE and 185 patients underwent conservative treatment. The lung metastases were examined by X-ray and CT scan. Results The median survival time in TACE group was 19.3 months compared with 10 months in control group. TACE group, 14 cases of lung metastasis, control group, 14 cases of lung metastasis, the difference between the two groups was not statistically significant. Univariate analysis showed tumor size, abnormal aminotransferase levels, and ultrasound echo associated with lung metastases. Multivariate analysis showed that tumor size was the only meaningful factor for lung metastasis. Conclusions Interventional chemoembolization is effective in prolonging the survival of patients with liver cancer, but it can not reduce the chance of lung cancer in liver cancer. Tumor size is the only predictor of lung metastases.