摘要
目的:分析肝细胞癌(HCC)患者经导管动脉化疗栓塞术(TACE)术前后甲胎蛋白(AFP)的变化,来预测肿瘤的变化和患者的生存期。方法:评估自2005年1月至2007年12月在复旦大学附属中山医院肝癌研究所接受TACE治疗的HCC患者的资料。根据患者TACE术前及术后1个月AFP浓度的变化,把患者分成3组:明显下降组、小幅下降组和无下降组。比较3组在生存期和疾病控制率(DCR)方面的差异,同时完成单因素和多因素变量分析。结果:在338例患者中,明显下降组患者113例、小幅下降组41例、无下降组184例。明显下降组、小幅下降组、无下降组中位生存期(月)和DCR(%)分别为:16.0和56.2;8.0和37.5;6.0和29.9,明显下降组患者的DCR和预后更优(P<0.001)。单因素和多因素分析提示,AFP下降幅度可作为预测总体生存期的独立因素(P<0.001)。结论:AFP下降幅度可作为HCC患者接受TACE治疗后,反映患者预后的一个临床指标。
Objective:To investigate the value ofα-fetoprotein(AFP)after transcatheter arterial chemoembolization(TACE)for predicting the prognosis of patients with hepatocellular carcinoma(HCC).Methods:Clinical data of patients with HCC who underwent TACE treatment in Liver Cancer Institute,Zhongshan Hospital from January 2005 to December 2007 were retrospectively evaluated.The AFP levels before TACE and one month after TACE were determined,and patients were divided into three groups accordingly as major AFP response group(major group),minor AFP response group(minor group),and no AFP response(no group)group.Overall survival(OS)and disease control rates(DCR)after TACE were compared among different AFP response groups.Univariate and multivariate analyses were performed.Results:Among 338 patients,113,41,and 184 patients were allocated to significantly declined,slightly declined and no decline group,respectively.The median OS(months)and DCR(%)were 16.0 and 56.2(major group),8.0 and 37.5(minor group),and 6.0 and 29.9(no group),respectively.Patients in major group had a significantly better DCR and prognosis(P<0.001).Moreover,univariate and multivariate analyses revealed that AFP response was an independent predictor for long-term survival(P<0.001).Conclusions:The AFP response to treatment can be used as a clinical index for the prognosis prediction of patients with HCC after TACE treatment.
作者
李立新
殷欣
王妍
薛同春
张岚
谢晓莺
王艳红
叶胜龙
任正刚
LI Li-xin;YIN Xin;WANG Yan;XUE Tong-chun;ZHANG Lan;XIE Xiao-ying;WANG Yan-hong;YE Sheng-long;REN Zheng-gang(Liver Cancer Institute, Shanghai Liver Tumor Clinical Medicine Center, Zhongshan Hospital, Fudan University, Shanghai 200032, China)
出处
《中国临床医学》
2021年第1期54-59,共6页
Chinese Journal of Clinical Medicine
关键词
甲胎蛋白
经肝动脉化疗栓塞术
肿瘤控制率
生存期
肝细胞肝癌
alpha-fetoprotein
transcatheter arterial chemoembolization
disease control rate
survival
hepatocellular carcinoma
