血清前白蛋白(PA)含量在肝脏TACE术患者预后中的临床价值
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摘要
目的:明确肝癌TACE术患者预后的影响因素,探讨术前前白蛋白含量在评估肝癌患者TACE术后远期预后中的价值。方法:回顾性分析上海长海医院中医肿瘤科2012年5月至2017年11月期间行肝脏TACE术的原发性肝癌患者病例资料及随访资料,用单因素分析及多因素回归分析术前多项临床参数对患者生存时间的影响。结果:共342例行肝脏TACE术的肝癌患者纳入研究。肿瘤大小、TNM分期、术前PA水平、血管侵犯是影响患者术后复发的独立危险因素。高PA组中位生存时间为29. 4个月,中PA组中位生存时间16. 8个月,低PA组中位生存时间为11. 0个月,三组组间差异有统计学意义。结论:术前前白蛋白PA含量低是肝癌患者TACE术后总生存期的独立危险因素。
Objective: To determine the prognostic factors of patients with liver cancer TACE,and to explore the value of preoperative albumin content in evaluating the long-term prognosis of patients with liver cancer after TACE.Methods: Primary liver cancer patients and follow-up data in TCM Oncology Department of Shanghai Changhai Hospital were retrospectively analyzed in May 2012-November 2017 during liver surgery using single factor analysis and multifactor regression analysis to analyse preoperative clinical data of patients survival time. Results: A total of 342 patients with liver cancer with TACE were included in the study. Tumor size,TNM staging,preoperative PA level,and vascular invasion were independent risk factors for postoperative recurrence. The median survival time in the high PA group was 29. 4 months,and the median survival time in the middle PA group was 16. 8 months,and the median survival time in the low PA group was 11. 0 months,and the difference in the three groups was statistically significant.Conclusion: The low content of preoperative albumin PA was an independent risk factor for total survival of patients with liver cancer after TACE.
Objective: To determine the prognostic factors of patients with liver cancer TACE,and to explore the value of preoperative albumin content in evaluating the long-term prognosis of patients with liver cancer after TACE.Methods: Primary liver cancer patients and follow-up data in TCM Oncology Department of Shanghai Changhai Hospital were retrospectively analyzed in May 2012-November 2017 during liver surgery using single factor analysis and multifactor regression analysis to analyse preoperative clinical data of patients survival time. Results: A total of 342 patients with liver cancer with TACE were included in the study. Tumor size,TNM staging,preoperative PA level,and vascular invasion were independent risk factors for postoperative recurrence. The median survival time in the high PA group was 29. 4 months,and the median survival time in the middle PA group was 16. 8 months,and the median survival time in the low PA group was 11. 0 months,and the difference in the three groups was statistically significant.Conclusion: The low content of preoperative albumin PA was an independent risk factor for total survival of patients with liver cancer after TACE.
引文
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[15]Chen Guowei,Tang Shuangqiao. Relationship between the level of serum CA125,prealbumin,cholinesterase and cirrhosis degree by Child-Pugh score[J]. Chinese Journal of Geriatrics,2018,37(3):295-297.[陈国伟,唐双桥.肝硬化Child-Pugh法分级与血清中糖类抗原125前白蛋白及胆碱酯酶的关系[J].中华老年医学杂志,2018,37(3):295-297.]
[16]Jiang N,Deng JY,Ding XW,et al. Prognostic nutritional index predicts postoperative complications and long-term outcomes of gastric cancer[J]. World Journal of Gastroenterology,2014,20(30):10537-10544.
[17]Tu MY,Chien TW,Chou MT. Using a nutritional screening tool to evaluate the nutritional status of patients with colorectal cancer[J]. Nutrition&Cancer,2012,64(2):323-330.
[18]Kawai H,Ota H. Low perioperative serum prealbumin predicts early recurrence after curative pulmonary resection for non-smallcell lung cancer[J]. World Journal of Surgery,2012,36(12):2853.
[2]Chen W,Zheng R,Baade PD,et al. Cancer statistics in China,2015[J]. Ca Cancer J Clin,2016,66(2):115-132.
[3]Zhai XF,Chen Z,Li B,et al. Traditional herbal medicine in preventing recurrence after resection of small hepatocellular carcinoma:a multicenter randomized controlled trial[J]. Journal of Integrative Medicine,2013,11(2):90-100.
[4]Jian Ping,Yang Zhou,Changqing Zhao,et al. Traditional Chinese medicine for treatment of liver diseases:progress,challenges and opportunities[J]. Journal of Integrative Medicine,2014,12(5):401-408.
[5]Yang Wanting,Hou Encun. The research progress of primary hepatic carcinoma treatment[J]. Modern Oncology,2016,24(21):3495-3499.[杨婉婷,侯恩存.原发性肝癌治疗的研究进展[J].现代肿瘤医学,2016,24(21):3495-3499.]
[6]Johnson SP,Ramasawmy R,Campbellwashburn AE,et al. Acute changes in liver tumour perfusion measured non-invasively with arterial spin labelling[J]. British Journal of Cancer,2016,114(8):897-904.
[7]Guo W,He X,Li Z,et al. Combination of transarterial chemoembolization(TACE)and radiofrequency ablation(RFA)vs surgical resection(SR)on survival outcome of early hepatocellular carcinoma:A meta-analysis[J]. Hepato-gastroenterology,2015,62(139):710.
[8]Suzana S,Boon PC,Chan PP,et al. Malnutrition risk and its association with appetite,functional and psychosocial status among elderly Malays in an agricultural settlement[J]. Malaysian Journal of Nutrition,2013,19(1):65.
[9]Saito M,Seo Y,Yano Y,et al. Short-term reductions in non-protein respiratory quotient and prealbumin can be associated with the long-term deterioration of liver function after transcatheter arterial chemoembolization in patients with hepatocellular carcinoma[J].Journal of Gastroenterology,2012,47(6):704-714.
[10]Fei L,Ling YC,Lan Z,et al. Model for end-stage liver disease combined with serum prealbumin to predict the prognosis of patients with decompensated liver cirrhosis[J]. Journal of Digestive Diseases,2010,11(6):352-357.
[11]Wang Zhichong,Song Fengbin. Assessment of nutritional status in patients with decompensated liver cirrhosis[J]. Journal of Clinical Hepatology,2017,20(2):236-237.[王治冲,宋风斌.失代偿期乙型肝炎肝硬化患者营养状况分析[J].实用肝脏病杂志,2017,20(2):236-237.]
[12]Zhai Yongzhen,Yue Yangyang,Ding Deping,et al. The value of serum prealbumin combined with MELD score in predicting the prognosis of patients with decompensated cirrhosis[J]. Chinese Journal of Hepatology,2017,25(7):533-535.[翟永贞,岳阳阳,丁德平,等.血清前白蛋白联合终末期肝病模型评分评估失代偿期肝硬化患者预后的临床价值[J].中华肝脏病杂志,2017,25(7):533-535.]
[13]Zhou Jing,Su Fei. Clinical features of 100 patients with acute exacerbation of cirrhosis with liver function decompensation[J].Journal of Clinical Hepatology,2016,19(3):314-317.[周静,苏菲.失代偿期肝硬化患者肝损伤急性加重100例临床分析[J]..实用肝脏病杂志,2016,19(3):314-317.]
[14]Zhao Xijun,Jin Guangzhi,Yang Ning,et al. Value of preoperative prealbumin content in assessing long-term prognosis of patients with hepatocellular carcinoma after hepatectomy[J]. Academic Journal of Second Military Medical University,2017,38(4):463-468.[赵喜君,金光植,杨宁,等.术前前白蛋白含量在评估肝癌患者肝切除术后远期预后中的价值[J].第二军医大学学报,2017,38(4):463-468.]
[15]Chen Guowei,Tang Shuangqiao. Relationship between the level of serum CA125,prealbumin,cholinesterase and cirrhosis degree by Child-Pugh score[J]. Chinese Journal of Geriatrics,2018,37(3):295-297.[陈国伟,唐双桥.肝硬化Child-Pugh法分级与血清中糖类抗原125前白蛋白及胆碱酯酶的关系[J].中华老年医学杂志,2018,37(3):295-297.]
[16]Jiang N,Deng JY,Ding XW,et al. Prognostic nutritional index predicts postoperative complications and long-term outcomes of gastric cancer[J]. World Journal of Gastroenterology,2014,20(30):10537-10544.
[17]Tu MY,Chien TW,Chou MT. Using a nutritional screening tool to evaluate the nutritional status of patients with colorectal cancer[J]. Nutrition&Cancer,2012,64(2):323-330.
[18]Kawai H,Ota H. Low perioperative serum prealbumin predicts early recurrence after curative pulmonary resection for non-smallcell lung cancer[J]. World Journal of Surgery,2012,36(12):2853.