摘要
目的分析145例肝癌合并2型糖尿病患者的临床资料,探讨肝动脉灌注化疗栓塞(TACE)的疗效及相关预后因素。方法回顾性分析145例肝癌合并2型糖尿病患者经TACE治疗的疗效及预后因素分析。生存率用Kaplan-Meier法计算,单因素分析采用Log-Rank方法,多因素分析采用Cox回归模型。结果 DM组与非DM组患者的总生存时间无统计学差异(P>0.05)。DM组患者较非DM组患者发生肝外转移率高,两组比较具有统计学意义(P<0.005)。分层分析显示:DM组中,空腹血糖≥8 mmol/L与空腹血糖<8 mmol/L相比,中位生存时间分别为15个月和30个月,具有统计学意义(P<0.001)。Cox多元回归分析显示:空腹血糖水平、肿瘤大小、ECOG评分、BCLC分期及门脉癌栓是影响HCC合并糖尿病患者预后的独立危险因素。结论空腹血糖水平可以作为影响HCC合并糖尿病患者疗效的独立预后因素。
Objective To evaluate the effect and prognostic factors of 145 cases of HCC patients with diabetes mellitus （DM） treated with TACE.MethodsA retrospective analysis about the effect and prognostic factors of TACE was conducted on 145 cases of HCC patients with DM. The survival rates were calculated using the Kaplan-Meier method. The log-rank method was used for univariate analysis, and the Cox regression model was used for multivariate analysis.Results There was no marked difference the 2 groups patients in postoperative overall survival （P〉0.05）. There was significant difference between the patients HCC with DM and those without DM in distant metastasis （P〈0.05）. The hierarchical analysis results show： DM group comparison between groups, Compared with fasting plasma glucose≥8 mmol/L HCC patients, patients with fasting plasma glucose 〈 8 mmol/L status, Statistically significant（P〈0.001）, The median survival time 15.0（95% CI 13.648-16.352）and 30.0（95% CI 24.979-35.021）, respectively. Multivariate analysis indicated fasting blood glucose level, tumor size 〉 8 cm, ECOG score, BCLC grade and PVTT were independent prognostic factors.Conclusions Inadequate maintenance of blood glucose in diabetic patients is a signiifcant risk factor for metastasis of HCC and for poor survival after curative TACE therapy.
出处
《中华介入放射学电子杂志》
2015年第1期13-17,共5页
Chinese Journal of Interventional Radiology：electronic edition
关键词
癌
肝细胞
肝动脉化疗栓塞术
糖尿病
预后
Carcinoma,hepatocellular
Transarterial chemoembolization
Diabetes mellitus
Prognosis
