摘要
目的 探讨原发性肝癌（HCC）患者经肝动脉化疗栓塞（TACE）治疗后,血清γ-谷氨酰转肽酶（GGT）对判断预后的价值.方法 回顾性分析2008年8月至2011年12月解放军总医院介入放射科接受TACE治疗的BCLC分期B期HCC患者162例,按术前血清GGT水平分为两组：高GGT组116例,正常GGT组46例,比较其生存情况及预后因素.结果 高GGT组和正常GGT组TACE治疗前GGT水平分别为（168＆#177;121）U/L和（33＆#177;9）U/L,差异有统计学意义（P＆lt;0.01）.两组患者的1、2、3年生存率分别为54.3%、33.6%、25.0%;87.0%、56.5%、41.3%.两组患者中位生存时间分别为23个月和36个月,差异有统计学意义（P=0.000）.Cox多元回归分析显示：术前GGT水平、肿瘤数目、肿瘤大小及血清甲胎蛋白浓度是BCLC B期HCC患者生存的独立危险因素.结论 TACE术前血清GGT水平可以作为判断TACE治疗BCLC分期B期HCC患者生存的独立预后因素.
Objective To evaluate the prognostic significance of serum GGT in patients with intermediate HCC （Barcelona Clinic Liver Cancer （BCLC） stage B） treated with TACE. Methods A retrospective analysis was conducted on 162 intermediate HCC patients receiving TACE treatment in 301 Hospital Department of Interventional Radiology from August 2008 to December 2011. Survival rates and prognostic significance were compared between the 116 patients （High GGT group） and 46 patients （normal GGT group）. The survival rates were calculated using the Kaplan-Meier method. The Log-rank method was used for univariate analysis, and the Cox regression model was used for multivariate analysis. Results The level of GGT was statistically different（P＆lt;0.01） in the high GGT group and normal GGT group before TACE, which was respectively （168＆#177;121） U/L and （33＆#177;9） U/L. After patients treated with TACE, the 1, 2 and 3 year survival rates were 54.3%,33.6% and 25.0%, respectively, and the median survival time was 23.0 months in the high GGT group. The 1, 2 and 3 year survival rates were 87.0%,56.5% and 41.3%, respectively, and the median survival time was 36.0 months in the normal GGT group. It has statistically signifcant（P=0.000） on the median survival time. It was showed that the survival rares （P＆lt;0.05） were relevanted with the following several aspects by univariate analysis： the level of serum GGT before TACE, hepatocirrhosis, Child score, tumor size, tumor numbers and serum AFP level, and the prognosis-related factors were relevanted with the following several aspects by Cox multiple regression analysis： the level of serum GGT before TACE, tumor nvmbers, serum AFP level and tumor size. Conclusion The level of GGT before TACE was an important prognostic factor to predict the effect of TACE on patients with intermediate HCC.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2014年第9期667-669,共3页
National Medical Journal of China
关键词
癌
肝细胞
栓塞
治疗性
预后
Carcinoma,hepatocellular
Embolization,therapeutic
Prognosis
