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目的 研究具有不同内在因素的肝癌在X -刀作用下对非癌组织的放射性效应。方法 选择肝癌体积、X 刀剂量基本相似条件下 ,以ALT(丙氨酸氨基转移酶 )为指标观察具有不同内在因素的肝癌于X 刀术后发生放射性肝损伤的危险性。结果 原发性肝癌于X 刀术后ALT上升值与术前比较具有显著性差异 (P <0 .0 0 1 )。原发性肝癌与转移性肝癌于X 刀术后ALT升、降之差及上升率比较差异非常显著 (P <0 .0 0 1 .P <0 .0 1 )。同时发现X 刀对原发性肝癌组中HBVM(+)和嗜酒因素均有者发生放射性肝损伤的危险性与这两种因素均无者比较差异非常显著 (P <0 .0 0 1 ,OR=2 7.5) ;与转移性肝癌比较亦具有非常显著性差异 (P <0 .0 0 1 ,OR =2 8.2 85)。结论 在X 刀治疗肝癌中对非癌肝组织具有放射性损伤者占 39.1 8% ;其程度及发生率以原发性肝癌为高 ,以同时伴有HBVM(+)及嗜酒因素者为重。
Objective To study the radiopharmaceutical effect of non-cancerous tissue of liver cancer with different internal factors under X-knife treatment. Methods The liver cancer with different internal factors was observed with ALT (alanine aminotransferase) as the indicator of liver cancer volume and X-knife dose. The risk of radiation-induced liver injury after X knife operation was observed. Results The increase of ALT in patients with primary liver cancer after X-knife was significantly different from that before operation (P <0.01). The differences of ALT rise and fall, and the rate of increase of ALT between primary hepatocellular carcinoma and metastatic liver cancer after X-knife surgery were significantly different (P <0.01, P <0.01). At the same time, it was found that the risk of radiation-induced liver injury in patients with HBVM (+) and alcohol consumption was significantly different from those in both of the two groups (P <0.01, OR = 2 7.5). Compared with metastatic liver cancer, there was also a significant difference (P <0.01, OR = 2 8.285). Conclusion The X-knife treatment of liver cancer in non-cancerous liver tissue with radioactive injury accounted for 39.1%; its extent and incidence of primary liver cancer is high, accompanied by both HBVM (+) and alcohol consumption as the most important.