甲胎蛋白对原发性肝癌患者TACE治疗效果及预后的评估价值
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摘要
目的研究甲胎蛋白对原发性肝癌经肝动脉灌注化疗栓塞术(transcatheter arterial chemo-embolization,TACE)治疗效果及患者预后的评估价值。方法选取行TACE原发性肝癌患者,根据TACE前后甲胎蛋白(AFP)浓度变化将其分为AFP升高组27例、AFP持平组28例、AFP降低组25例,对3组患者进行疗效评估和生存分析,对比其疾病控制率、生存率和满意度及血清学指标。结果 3组患者疾病控制率(DCR),AFP降低组为96. 00%,AFP持平组为64. 29%,AFP升高组为40. 74%,3组差异有统计学意义(P <0. 05)。3组患者3个月、6个月、12个月、24个月的生存率均为AFP降低组> AFP持平组> AFP升高组,差异有统计学意义(P <0. 05)。3组患者手术满意率分别为88. 0%、71. 4%、59. 3%,差异有统计学意义(P <0. 05)。患者血清中白细胞、中性粒细胞百分比、血小板、丙氨酸氨基转移酶的含量AFP降低组 AFP持平组> AFP升高组,差异有统计学意义(P <0. 05)。结论甲胎蛋白能够作为原发性肝癌患者预后疗效评估的参考,值得临床给予关注。
Objective To evaluate the therapeutic value of alpha-fetoprotein in the treatment of primary hepatocellular carcinoma with transcatheter arterial chemo-embolization( TACE) and the prognosis of patients. Methods Patients with TACE primary liver cancer were enrolled. According to the changes of alpha-fetoprotein( AFP) concentration before and after TACE,they were divided into 27 patients with AFP elevation group,28 patients with AFP-flat group,and 25 patients with AFP-reduced group. And survival analysis,comparing their disease control rate,survival rate and satisfaction,serological indicators. Results The disease control rate( DCR) of the three groups was 96. 00% in the AFP group,64. 29% in the AFP group,and 40. 74% in the AFP group. The difference was statistically significant( P < 0. 05). The survival rates of the 3 groups,3 months,6 months,12 months,and 24 months were all in the AFP-reduced group > AFP-flat group > AFP-raised group,and the difference was statistically significant( P < 0. 05). The surgical satisfaction rates of the three groups were 88. 0%,71. 4%,and 59. 3%,respectively,and the difference was statistically significant( P < 0. 05). The serum levels of leukocytes,neutrophils,platelets,and alanine aminotransferase in patients with AFP decreased in the AFP-flat group < AFP-increased group,the difference was statistically significant( P < 0. 05),platelets,alanine The percentage of aminotransferase in AFP group was lower than that in AFP group > AFP group( P < 0. 05). Conclusion Alpha-fetoprotein can be used as a reference for evaluating the prognosis of patients with primary liver cancer,and it is worthy of clinical attention.
Objective To evaluate the therapeutic value of alpha-fetoprotein in the treatment of primary hepatocellular carcinoma with transcatheter arterial chemo-embolization( TACE) and the prognosis of patients. Methods Patients with TACE primary liver cancer were enrolled. According to the changes of alpha-fetoprotein( AFP) concentration before and after TACE,they were divided into 27 patients with AFP elevation group,28 patients with AFP-flat group,and 25 patients with AFP-reduced group. And survival analysis,comparing their disease control rate,survival rate and satisfaction,serological indicators. Results The disease control rate( DCR) of the three groups was 96. 00% in the AFP group,64. 29% in the AFP group,and 40. 74% in the AFP group. The difference was statistically significant( P < 0. 05). The survival rates of the 3 groups,3 months,6 months,12 months,and 24 months were all in the AFP-reduced group > AFP-flat group > AFP-raised group,and the difference was statistically significant( P < 0. 05). The surgical satisfaction rates of the three groups were 88. 0%,71. 4%,and 59. 3%,respectively,and the difference was statistically significant( P < 0. 05). The serum levels of leukocytes,neutrophils,platelets,and alanine aminotransferase in patients with AFP decreased in the AFP-flat group < AFP-increased group,the difference was statistically significant( P < 0. 05),platelets,alanine The percentage of aminotransferase in AFP group was lower than that in AFP group > AFP group( P < 0. 05). Conclusion Alpha-fetoprotein can be used as a reference for evaluating the prognosis of patients with primary liver cancer,and it is worthy of clinical attention.
引文
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[13] Shalapour S,Lin XJ,Bastian IN,et al. Inflammation-induced Ig A+cells dismantle anti-liver cancer immunity〔J〕. Nature,2017,55(80):340-342.
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[15] Asahi Y,Kamiyama T,Homma S,et al. Resection of liver metastasis derived from alpha-fetoprotein-producing gastric cancer-report of 4 cases〔C〕. International Cancer Conference Journal. Springer Japan,2016,5(2):98-103.
[2] Glantzounis GK,Kyrochristos ID,Ziogas DE,et al. Novel translational therapeutic strategy by sequencing primary liver cancer genomes〔J〕. Future Oncology,2017,5(3):1049-1052.
[3]陈秋英,马荣芬,时秀菊,等.肝动脉化疗栓塞术对原发性肝癌患者血清甲胎蛋白异质体和肝功能的影响〔J〕.河北医药,2017,39(13):1948-1951.
[4] Cheng D,Fu Y,Zhao Y,et al. Risk factors of disease progression and death in patients with HBV-related primary liver cancer〔J〕. International Journal of Clinical Experimental Medicine,2017,10(1):1320-1324.
[5] Zhu M,Li W,Lu Y,et al. HBx drives alpha fetoprotein expression to promote initiation of liver cancer stem cells through activating PI3K/AKT signal pathway〔J〕. International Journal of Cancer,2017,140(6):1346-1355.
[6]袁征,柯文炳.肝动脉栓塞化疗联合超声引导下瘤内无水酒精注射治疗对肝癌患者血清甲胎蛋白和生存情况的影响〔J〕.中国肿瘤临床与康复,2016,23(11):1331-1333.
[7]韩鲁军,张红欣,许会军,等.奥沙利铂联合参芪扶正注射液对原发性肝癌患者AFP与GP73水平的影响及临床疗效〔J〕.现代生物医学进展,2016,16(22):4289-4291.
[8] Sanghvi SM,Lischalk JW,Ling C,et al. Clinical outcomes of gastrointestinal brain metastases treated with radiotherapy〔J〕. Radiation Oncology,2017,12(1):43-46.
[9]郑海伦,赵睿,李大鹏,等.肿瘤标志物DCP和AFP在原发性肝癌中的诊断价值〔J〕.中华全科医学,2016,14(1):29-31.
[10]庾少梅,林珠,连炬飞,等.联合检测CHE、AFU及AFP与原发性肝癌的相关性研究〔J〕.国际检验医学杂志,2015,11(13):1821-1822.
[11] FU,Wei Y,Zheng D,et al. Triplet anti-tumor therapy based on thymosinα-1 attenuates incidence of hepatoma and serum alpha-fetoprotein level in rat hepatoma model〔J〕. Chinese Journal of Cellular&Molecular Immunology,2015,31(6):744-750.
[12]魏容,梁艳丽,王明霞,等. AFP、NLR、PLT及部分凝血指标在原发性肝癌治疗中的相关性分析〔J〕.贵州医科大学学报,2017,9(11):1-5.
[13] Shalapour S,Lin XJ,Bastian IN,et al. Inflammation-induced Ig A+cells dismantle anti-liver cancer immunity〔J〕. Nature,2017,55(80):340-342.
[14]赵倩,王小平,胥冰,等.甲胎蛋白与肝癌免疫的研究进展〔J〕.生物学杂志,2016,33(2):95-99.
[15] Asahi Y,Kamiyama T,Homma S,et al. Resection of liver metastasis derived from alpha-fetoprotein-producing gastric cancer-report of 4 cases〔C〕. International Cancer Conference Journal. Springer Japan,2016,5(2):98-103.