The Evaluation For Clinical Prognotic Factors Of Primary Liver Carcinoma Treated In 200 Cases With Interventional Therapy

Objective:Primary liver cancer is one of the common malignant tumor. It's mortality lies the second. In recent years, because the means of treating liver cancer are developing quickly, the survival time of patients have extended and the mortality have improved. To understand the general situation of primary liver cancer patients and further explore the prognostic factors, this study select 200 cases of primary liver cancer patients who treated with interventional therapy in changzhi city, shanxi province. We can understand which are risk factors or protective factors of primary liver cancer, and provide an objective basis for interventional therapy.Methods:select 200 cases of primary liver cancer patients who treated with interventional therapy in changzhi city, shanxi province from June 2001 to June 2009. All patients fit the clinical diagnosis standard of liver cancer which is established by China liver professional committee in 2001. All the data we collected was saved with Epidata and analyzed with SPSS 13.0 software. We describe the general situation of PLC patients, then estimate the survival rate and explore prognostic factors. Use a chi-square test to analyze Classification data and survival analysis to analyze prognostic factors. We use a Kaplan-Meier method to estimate survival rate, log-rank test to compare survival curves between groups, Cox regression model to analysis influence factors of survival rate.Result:(1) The number of collected cancer patients is 200. There are 159 men(79.5%), and 41 women(20.5%). The rang of age is from 32 to 95 (60.70±10.325). There are 35(17.5%) patients treated with transcatheter arterial infusion (TAI), and 165(82.5%) patients treated with transcatheter arterial chemoembolization (TACE).(2) Patients who has hepatitis B and familial history are easily with portal hypertension, portal vein thrombosis, extrahepatic metastases and positive HBsAg and AFP. Patients who are liver cell adenocarcinomas are easily with portal hypertension, extrahepatic metastases, positive HBsAg and rich supply of blood. Patients who are diffuse liver carcinoma are easily with portal hypertension, extrahepatic metastases and positive HBsAg.(3) The median survival time of PLC patients was 18 (month). The 1year,2 year,3 year survival rates are 79%,33%, and 8%. The 4,5,6 year survival rates keep 4%. The 7 year survival rate decreased to 0%. (4) The result of log-rank tests shows that factors may affect the prognosis of patients with liver cancer are:comorbidity, family history, liver area bump, portal hypertension, tissue typing, general typing, dividing line, portal vein thrombosis, extrahepatic metastases, AFP, operation and blood.(5) The result of Cox regression shows that factors affect the prognosis of patients are: portal hypertension, general typing, tissue necrosis, extrahepatic metastases, HBsAg and blood. The survival rate of patients who has portal hypertension, tissue necrosis, extrahepatic metastases is lower, while who has small liver carcinoma, negative HBsAg, rich supply of blood is higher.Conclusion:Transcatheter arterial chemoembolization (TACE) is effective and safe to liver cancer patients who don't fit an operation. The prognosis of patients who has portal hypertension, tissue necrosis, extrahepatic metastases, diffuse liver carcinoma, positive HBsAg, deficient supply of blood is worse. These patients need be treated not only interventional therapy but also other therapy, comprehensive treatment can further enhance the effect.