摘要
目的探讨血清甲胎蛋白(AFP)、谷草转氨酶与血小板比值指数(APRI)及γ⁃谷氨酰转肽酶(GGT)/谷丙转氨酶(ALT)检测对原发性肝癌(PHC)经动脉化疗栓塞(TACE)患者预后的预测价值。方法选取2020年6月至2023年6月保定市第二中心医院收治的120例PHC经TACE患者,随访1年,据肿瘤治疗疗效分为预后不良组(n=29)和预后良好组(n=91),比较两组临床基线资料、APRI、血小板/淋巴细胞比值(PLR)、GGT、AFP、ALT及GGT/ALT等差异,用Logistic多因素分析PHC经TACE患者预后影响因素,用受试者工作特征(ROC)曲线分析血清AFP、APRI、GGT/ALT水平检测对PHC经TACE患者预后的预测价值。结果预后良好组的肝外转移、Child⁃Pugh B级、肿瘤大小和数目、APRI、PLR、GGT、AFP、ALT及GGT/ALT低于预后不良组,差异有统计学意义(P<0.05);多因素Logistic回归分析结果显示,肿瘤大小和数目、肝外转移、Child⁃Pugh B级、APRI、PLR、GGT、AFP、ALT及GGT/ALT为影响PHC经TACE患者预后不良的独立危险因素(P<0.05);ROC曲线结果显示血清AFP、APRI、GGT/ALT单项及联合检测预测PHC经TACE患者预后的曲线下面积(AUC)分别为0.799、0.815、0.792、0.918,联合预测效能高于单项预测(P<0.05)。结论AFP、APRI、GGT/ALT检测对PHC经TACE患者预后具有较高的预测价值,且联合预测价值更高,为评估PHC患者预后提供参考。
Objective To investigate the prognostic value of serum alpha⁃fetoprotein(AFP),serum glutamic oxalacetic transaminase to platelet ratio index(APRI)and gamma⁃glutamyl transaminase(GGT)/alanine transaminase(ALT)in patients with primary liver cancer(PHC).Methods A total of 120 PHC patients with TACE treated at the Second Central Hospital of Baoding City from June 2020 to June 2023 were selected for a one⁃year followed⁃up.Based on the therapeutic outcomes,they were categorized into a poor prognosis group(n=29)and a good prognosis group(n=91).Clinical baseline data,APRI,platelet/lymphocyte ratio(PLR),GGT,AFP,ALT,and GGT/ALT levels were compared between the two groups.The influencing factors of PHC patients with TACE were analyzed by logistic multivariate analysis.Additionally,receiver operating characteristic(ROC)curve was used to assess the value of serum AFP,APRI,and GGT/ALT levels in predicting poor prognosis in PHC patients undergoing TACE.Results The extrahepatic metastasis,Child⁃Pugh B,tumor size and number,APRI,PLR,GGT,AFP,ALT,and GGT/ALT in the good prognosis group were significantly lower than those in the poor prognosis group(P<0.05).Multivariate logistic regression analysis showed that tumor size and number,extrahepatic metastasis,Child⁃Pugh B,APRI,PLR,GGT,AFP,ALT,and GGT/ALT were all independent risk factors for the poor prognosis group of PHC patients undergoing TACE(P<0.05).ROC curve results showed that the area under the curve(AUC)of serum AFP,APRI,GGT/ALT,and the combined detection were 0.799,0.815,0.792 and 0.918,respectively.The combined prediction of AFP,APRI and GGT/ALT was significantly higher than the single prediction(P<0.05).Conclusion AFP,APRI,and GGT/ALT detection have a high predictive value for the prognosis of PHC patients undergoing TACE.This provides a valuable reference for evaluating the prognosis of PHC patients.
作者
槐聪颖
张鑫鑫
崔玉秀
HUAI Congying;ZHANG Xinxin;CUI Yuxiu(Department of Clinical Laboratory,the Second Central Hospital of Baoding,Baoding,Hebei,China,072750)
出处
《分子诊断与治疗杂志》
2025年第1期132-136,共5页
Journal of Molecular Diagnostics and Therapy
基金
河北省医学科学研究课题项目(1951ZF033)。
关键词
原发性肝癌
动脉化疗栓塞
甲胎蛋白
谷草转氨酶与血小板比值指数
γ⁃谷氨酰转肽酶
谷丙转氨酶
Primary liver cancer
Arterial chemoembolization
Alpha-fetoprotein
Aspartate aminotransferase-to-platelet ratio index
Gamma-glutamyl transaminase
Alanine transaminase
