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背景与目的:肝癌是我国的高发恶性肿瘤,预后较差。本研究通过分析我院维吾尔族原发性肝癌病例,旨在发现影响其长期生存的预后因素,并分析不同治疗模式的疗效差异。方法:回顾性分析246例维吾尔族原发性肝癌患者的临床资料,应用Kaplan-Meier方法计算生存率,对可能影响患者预后的因素采用Log-rank检验进行单因素分析,并用COX回归模型进行多因素分析,以筛选出独立的预后因素。结果:246例患者总的中位生存期(overall survival,OS)为10.7个月。1、2、3、5年生存率分别为41.97%、22.13%、14.87%和8.92%。多因素分析显示,患者年龄(P=0.003)、肿瘤分期(P=0.000)、门脉癌栓(P=0.000)、Child-Pugh分级(P=0.000)及血清LDH水平(P=0.000)是影响患者生存的独立因素。应用手术、肝动脉化疗栓塞术(transcatheter hepatic arterial chemoembolization,TACE)、放化疗、射频消融(radiofrequencyablation,RFA)等治疗手段的患者中位OS为19.2个月,对症支持治疗患者中位OS仅为9.1个月。综合治疗疗效优于单一治疗,其中以手术为主的综合治疗中位OS达到64.9个月。结论:患者年龄、肿瘤分期、门脉癌栓、Child-Pugh分级及血清LDH水平是影响维吾尔族原发性肝癌患者预后的重要独立因素。而采用手术切除、TACE、放化疗、RFA等治疗的总体疗效显著高于支持对症治疗。综合治疗的疗效优于单一治疗,而以手术切除为主的综合治疗是较理想的治疗手段。
Background and Objective: Liver cancer is a high-grade malignant tumor in China with poor prognosis. This study analyzed Uygur patients with primary liver cancer cases in our hospital to find the prognostic factors that affect their long-term survival and to analyze the differences in the efficacy of different treatment modalities. Methods: The clinical data of 246 Uighur patients with primary liver cancer were retrospectively analyzed. The Kaplan-Meier method was used to calculate the survival rate. Log-rank test was used to analyze the factors that may influence the prognosis of patients. One-way analysis was performed with COX regression model Factor analysis to screen out independent prognostic factors. Results: The overall median survival (OS) of 246 patients was 10.7 months. The 1, 2, 3, 5-year survival rates were 41.97%, 22.13%, 14.87% and 8.92% respectively. Multivariate analysis showed that patient age (P = 0.003), tumor stage (P = 0.000), portal vein tumor thrombus (P = 0.000), Child-Pugh classification (P = 0.000) and serum LDH level (P = 0.000) Independent factors affecting patient survival. The median OS was 19.2 months in patients treated with transcatheter hepatic arterial chemoembolization (TACE), chemoradiation and radiofrequency ablation (RFA), and the median OS was only 9.1 in symptomatic supportive care patients Months. The curative effect of integrated therapy was better than that of single therapy, and the median OS of the operation-based comprehensive treatment reached 64.9 months. Conclusion: Age, tumor stage, portal vein tumor thrombus, Child-Pugh classification and serum LDH level are the important independent factors affecting the prognosis of Uygur patients with primary liver cancer. The overall efficacy of surgical resection, TACE, radiotherapy and chemotherapy, RFA treatment was significantly higher than the support symptomatic treatment. The curative effect of the comprehensive treatment is superior to the single treatment, and the comprehensive treatment based on the surgical resection is the ideal treatment method.