肝动脉介入化疗栓塞术后甲胎蛋白的应答对进展期肝癌预后的影响

摘要/Abstract

摘要： 目的评价甲胎蛋白(AFP)应答对进展期肝细胞癌(HCC)患者行肝动脉介入化疗栓塞术(TACE)长期预后的影响。方法回顾性分析我院符合巴塞罗那分期B期的165例进展期HCC患者,根据TACE术后AFP是否下降50%分为两组:AFP应答组(n=80)和AFP未应答组(n=85)。采用Kaplan-Meier计算总体生存时间,Log-rank检验评估不同组别患者的生存差异,Cox比例风险模型分析影响总体生存的独立危险因素。结果一般临床资料两组比较差异无统计学意义。AFP应答组的1,3,5年总体生存率为68.9%,46.6%和40.8%,AFP未应答组为45.9%,20%和17.5%,经Log-rank检验,差异有统计学意义(P=0.001)。Cox多因素比例风险模型分析发现,AFP>400 ng/ml(HR:2.12,P=0.001)、肿瘤直径>5 cm(HR:3.33,P<0.001)、肿瘤数目>3(HR:2.06,P=0.001)、以及Child-Pugh B级(HR:1.93,P=0.004)是影响TACE预后独立的危险因素,AFP应答(HR:0.45,P<0.001)是TACE术后生存的保护因素。结论连续AFP测量是TACE术后监测治疗反应的有效方法,AFP应答可提高进展期HCC行TACE后的长期生存。

关键词: 肝细胞癌, 甲胎蛋白, 肝动脉化疗栓塞术, 生存

卢先东, 时国兵. 肝动脉介入化疗栓塞术后甲胎蛋白的应答对进展期肝癌预后的影响[J]. 肝脏, 2018, 23(8): 689-692.

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