血清PIVKA-Ⅱ和AFP-L3水平对肝细胞癌行TACE术后病情和预后评估的价值研究

摘要/Abstract

摘要： 目的探讨血清异常凝血酶原(PIVKA-Ⅱ)和甲胎蛋白异质体3(AFP-L3)联合检测在肝细胞癌(HCC)经动脉化疗栓塞(TACE)术治疗后的临床应用价值。方法选取63例行TACE的HCC患者,根据肝脏病灶直径变化分为缩小＞50%亚组和＜50%亚组,根据疗效分为完全缓解(CR)、部分缓解(PR)、疾病稳定(SD)和疾病进展(PD)亚组。分别检测血清PIVKA-Ⅱ和AFP-L3水平,并进行Pearson分析。结果术后4周和术后8周的血清PIVKA-Ⅱ和AFP-L3水平低于手术前,且呈递减趋势(F=12.478,10.719,均P<0.05)。肝脏病灶直径缩小＞50%亚组的血清PIVKA-Ⅱ和AFP-L3水平低于＜50%亚组(t=7.873,8.264,均P<0.05);CR组的血清PIVKA-Ⅱ和AFP-L3水平低于PR、SD和PD组,且呈递增趋势(F=15.682,9.825,均P<0.05)。经过Pearson相关分析,血清PIVKA-Ⅱ和AFP-L3水平联合检测的敏感度和特异度高于单项指标检测(87.61%,93.26%,均P<0.05)。结论血清PIVKA-Ⅱ和AFP-L3水平联合检测对TACE术后HCC患者病情和预后评估具有较高的临床价值。

关键词: 肝细胞癌, 经动脉化疗栓塞术, PIVKA-Ⅱ, AFP-L3

Abstract: Objective To investigate the clininal value of joint detection of abnormal serum prothrombin (PIVKA-Ⅱ) and AFP different plastid 3 (AFP-L3) in patients with primary hepatocellular carcinoma (HCC) after conventional transcatheter arterial chemoembolization (TACE) therapy. Methods 63 HCC patients who underwent TACE were divided into >50% and <50% reduction subgroups according to the change of liver lesion size (in diameter), and into complete response (CR), partial response (PR), disease stability (SD) and disease progression (PD) subgroups according to the efficacy. Serum PIVKA - Ⅱ and AFP - L3 levels was detected and analyzed with Pearson analysis. Results Serum PIVKA-Ⅱ and AFP-L3 levels at 4 weeks and 8 weeks after surgery were lower than those before surgery, and showed a decreasing trend (F=12.478, 10.719, both P<0.05). Serum PIVKa-Ⅱ and AFP-L3 levels in >50% reduction subgroup were lower than those in <50% subgroup (t=7.873, 8.264, all P<0.05). Serum PIVKa-Ⅱ and AFP-L3 levels in CR group were lower than those in PR, SD and PD groups, and showed an increasing trend in these groups, respectively (F=15.682, 9.825, all P<0.05). After Pearson correlation analysis, the sensitivity and specificity of combined detection of serum PIVKa-Ⅱ and AFP-L3 levels were higher than those of single index detection (87.61% and 93.26%, both P<0.05). Conclusion A joint detection of PIVKA Ⅱ and serum AFP - L3 levels has high clinical value for evaluating the prognosis of HCC patients post TACE therapy.

Key words: Hepatocellular carcinoma, Transcatheter arterial chemoembolization therapy, PIVKA-Ⅱ, AFP-L3

季琴, 沈预程, 邵春燕. 血清PIVKA-Ⅱ和AFP-L3水平对肝细胞癌行TACE术后病情和预后评估的价值研究[J]. 肝脏, 2022, 27(2): 210-212.

JI Qin, SHEN Yu-chneg, SHAO Chun-yan. The value of PIVKA Ⅱ and serum AFP - L3 levels for evaluating the prognosis of primary liver cancer after TACE Therapy[J]. Chinese Hepatolgy, 2022, 27(2): 210-212.

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