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1、DOI：10-16016/j.1000-5404.201502002原发性肝癌首次TACE治疗时RIPA参与肿瘤供血的影响因素分析罗家敏，罗小平，刘曦，何明菊，杨伟(重庆医科大学附属第二医院放射科，重庆400010)［摘要］目的分析原发性肝癌首次经动脉插管化疗栓塞时右侧膈下动脉(rightinferiorphrenicartery,RIPA)参与肿瘤供血的相关影响因素，作为术前判断其是否存在供血的重要参考依据。方法冋顾性分析我院161例原发性肝癌首次行插管化疗栓塞时即行右侧嗝下动脉造影者的MRI或CT、DSA资料，按肿瘤是否有RIPA参与供血分RIPA
2、纟H.与NRIPA组，分析两组病例肿瘤大小、位置、包膜，并对其行单因素分析及多因素logistic冋归分析。结果161例屮RIPA参与肿瘤供血77例(47.8%),单因素分析显示肿瘤大小(P<0.01)、是否累及肝包膜(P二0.034)、肿瘤有无完整包膜(P〈0.01)、肿瘤主要部分所在肝段(P<0.01)在两组间有统计学差异,多因素logistic回归分析显示肿瘤大小分类、有无完整包膜及肿瘤主要部分所在肝段为首次TACE治疗时RIPA参与肿瘤供血的独立预测因素。结论原发性肝癌首次TACE治疗时，当肿瘤为位于肝裸区或膈下的大肝癌，尤其是位于VTT段且无
3、完蔡包膜者，RIPA参与肿瘤供血的机会增加。［关键词］原发性肝癌；经动脉插管化疗栓塞；右侧嗝下动脉；肿瘤血供；影响因素［中图法分类号］R735.7；R453.9；R322.1+21［文献标志码］AAnalysisaboutcausativefactorsofRIPAparticipatinginthebloodsupplyofPLCatinitialTACEsessionLuoJiamin,LuoXiaoping,LiuXi,HeMingju,YangWei(DepartmentofRadiology,SecondAffiliatedHospital,
4、ChongqingMedicalUniversily,Chongqing,400010,China)[Abstract]ObjectiveAnalyzethecaustitivefactorsofRIPAparticipatinginthebloodsupplyofPLCatinitialTACEsession,soastoprovideimportantreferenceforjudgingwhetherthereisbloodsupplyfromRIPAbeforeTACE.MethodsRetrospectivelyanalyzetheradio
5、graphicmaterialsof161patientswithPLCwhounderwentRIPAangiographyatthefirstTACEtreatmentinourhospital,wedividedallpatientsintoRIPAgroupandNRIPAgroupaccordingtowhetherRIPAparticipatesintumorbloodsupplyornot.Evaluatetumorsizejocationandtumorcapsulebetweenthetwogroups,Univariateandmu
6、ltivariateanalyseswereperformedinthisstudy.Results77cases(47.8%)werefoundedtohavethebloodsupplyfromRIPAatinitialTACEsession,Univariateanalysisshowedthattumorsize(P<0.01),involvingthelivercapsule(P=0.034),tumorcapsule(P<0.01)andtumor'sliversegment(P<0.01)weresignificantlyassociat
7、edwiththebloodsupplyfromRIPAinPLCatinitialTACEsession,Multiplelogisticregressionanalysisshowedthattheclassificationoftumorsize,tumor^sliversegmentandtumorcapsulewereindependentpredictivefactorsofwhetherthePLChasbloodsupplyfromRIPAornotatinitialTACEsession.ConclusionWhenPLCisloca
8、tedinthebareareaordirectlybeneaththediaphragman
