肝癌合并门静脉癌栓患者的癌栓碘化油沉积与预后关系
Relationship between lipiodol deposition in portal vein tumour thrombus and prognosis in patients with primary hepatic cancer complicated with portal vein tumor thrombosis
岳衍晓 1刘吉兵 2李辉 3宁尚昆 2马翔宇 2原晓红 4王睛5
作者信息
- 1. 山东省肿瘤防治研究院(山东省肿瘤医院)介入科,山东第一医科大学(山东省医学科学院),山东济南 250117;济宁市第一人民医院介入放射科,山东济宁 272011
- 2. 山东省肿瘤防治研究院(山东省肿瘤医院)介入科,山东第一医科大学(山东省医学科学院),山东济南 250117
- 3. 济宁市第一人民医院介入放射科,山东济宁 272011
- 4. 山东第一医科大学第三附属医院骨科,山东济南 250031
- 5. 济宁市第一人民医院门诊部,山东济宁 272011
- 折叠
摘要
目的 探讨原发性肝癌合并门静脉癌栓的患者经TACE联合靶向药物治疗后,门静脉癌栓的碘化油沉积情况与患者生存期、生活质量及临床并发症关系.方法 选取山东省肿瘤医院2015-05-01-2019-04-03及山东省济宁市第一人民医院2018-01-01-2019-12-02收治的原发性肝癌合并门静脉癌栓的患者74例纳入研究,根据门静脉癌栓碘化油的沉积情况分为碘化油沉积良好组(A组,39例)和沉积差或无沉积组(B组,35例).比较2组无进展生存期(PFS)、总生存期(OS)以及临床并发症发生率.结果 A组中位OS为29(21.1～36.9)个月,B组中位OS为9(5.8～12.2)个月,2组OS各时点死亡率差异有统计学意义,x2=26.308,P＜0.001;A组中位PFS为19(15.4～22.6)个月,B组中位PFS为6(2.6～9.4)个月,x2=19.766,P＜0.001.A组并发症发生率为74.4％,B组并发症发生率为68.6％,x2=0.304,P=0.615.2组癌栓Ⅰ型患者OS各时点死亡率差异有统计学意义,x2=4.174,P=0.041;2组癌栓Ⅱ型患者PFS各时点死亡率差异有统计学意义,x2=4.119,P=0.042;2组癌栓Ⅱ型患者各时点OS死亡率差异有统计学意义,x2=3.902,P=0.048;2组癌栓Ⅲ+Ⅳ型患者各时点PFS死亡率差异有统计学意义,x2=24.784,P＜0.001;2组癌栓Ⅲ+Ⅳ型患者各时点OS死亡率差异有统计学意义,x2=24.013,P＜0.001.结论 癌栓碘化油沉积是影响患者预后的重要因素,沉积良好的患者预后良好.癌栓碘化油沉积情况与患者并发症发生率无明显关联.癌栓分型会对癌栓碘化油沉积良好和沉积差者的PFS、OS产生影响.
Abstract
Objective To investigate the association of lipiodol deposition in portal vein tumor thrombus(PVTT)with the survival time,quality of life and clinical complications in patients who have primary hepatic cancer(PHC)complicated with PVTT after transcatheter arterial chemoembolization(TACE)combined with targeted drugs.Methods Retrospec-tive analysis was performed in 74 patients who have primary hepatic cancer complicated with PVTT in the Department of Interventional of Shandong Cancer Hospital from May 1,2015 to April 3,2019 and Jining First People's Hospital from January 1,2018 to December 2,2019.The patients were divided into two groups by the deposition of lipiodol in PVTT,with 39 cases in the well-deposited lipiodol group(group A)and 35 cases in the poor or no deposition group(group B).Progression free survival(PFS),overall survival(OS),and incidence of clinical complications were compared between the two groups.Results The median OS of the group A was 29(21.1-36.9)months,and the median OS of the group B was 9(5.8-12.2)months.There was a statistically significant difference in mortality rates at various time points of OS be-tween the two groups(x2=26.308,P＜0.001).The median PFS of the group A was 19(15.4-22.6)months,and the median PFS of the group B was 6(2.6-9.4)months(x2=19.766,P＜0.001).The incidence rate of complication in the group A was 74.4％and 68.6％in Group B.The incidence of complication of the two groups did not differ significantly(x2=0.304,P=0.615).The test result showed the OS difference of the two groups for PVTT type Ⅰ at every time point was statistically significant(x2=4.174,P=0.041).The result showed the PFS difference of the two groups for PVTT type Ⅱ at every time point was statistically significant(x2=4.119,P=0.042),and there was a statistically significant difference in OS mortality rates at various time points between the two groups of PVTT type Ⅱ(x2=3.092,P=0.048).The PFS and OS differences of the two groups for PVTT type Ⅲ+Ⅳ at every time point were statistically significant(x2=24.784,P＜0.001;x2=24.013,P＜0.001).Conclusion Lipiodol deposition of tumor thrombus is a major factor af-fecting the prognosis of patients,and patients with good deposition have satisfactory prognosis.Also,it is not significantly associated with the incidence of complications.The type of PVTT can make differences to the PFS and OS of patients with good and poor lipiodol deposition.
关键词
原发性肝癌/门静脉癌栓/肝动脉化疗栓塞术/碘化油沉积/靶向药物Key words
primary hepatocellular carcinoma/portal vein tumor thrombus/transcatheter arterial chemoembolization/lipiodol deposition/targeted drugs引用本文复制引用
出版年
2024
NETL
NSTL
万方数据