摘要
目的分析肝细胞癌患者发生经导管肝动脉化疗栓塞(TACE)抵抗的影响因素。方法回顾性收集并分析2020年1月至2021年12月在徐州医科大学附属医院行TACE治疗的106例肝细胞癌患者资料,其中男性90例,女性16例,年龄(59.9±9.3)岁。根据患者术后是否发生TACE抵抗分为TACE抵抗组(n=47)和对照组(n=59)。比较两组首次TACE术前甲胎蛋白、异常凝血酶原、肿瘤数目、肿瘤血管强化类型(影像学检查)、肿瘤最大径等指标。多因素logistic回归分析肝细胞癌患者发生TACE抵抗的影响因素。结果TACE抵抗组中甲胎蛋白>400μg/L、异常凝血酶原>40 AU/L、肿瘤多发、肿瘤血管强化Ⅲ+Ⅳ型(不均匀强化)比例高于对照组,差异均有统计学意义(均P<0.05)。TACE抵抗组肿瘤最大径高于对照组,差异有统计学意义(Z=-2.41,P=0.016)。多因素logistic回归分析,术前甲胎蛋白>400μg/L(OR=2.707,95%CI:1.008~7.271)、肿瘤多发(OR=6.069,95%CI:2.115~17.415)、肿瘤血管强化Ⅲ+Ⅳ型(OR=7.813,95%CI:2.246~27.176)的肝细胞癌患者发生TACE抵抗风险增加(均P<0.05)。结论术前甲胎蛋白>400μg/L、肿瘤多发以及肿瘤血管强化Ⅲ+Ⅳ型是肝细胞癌患者发生TACE抵抗的独立危险因素。
Objective To study the risk factors of patients with hepatocellular carcinoma(HCC)to transcatheter arterial chemoembolization(TACE)refractoriness.Methods The clinical data of 106 HCC patients who underwent TACE at the Affiliated Hospital of Xuzhou Medical University from January 2020 to December 2021 were retrospectively studied.There were 90 males and 16 females,with the age of(59.9±9.3)years.These patients were divided into the TACE-refractory group(n=47)and the control group(n=59)based on whether TACE refratoriness occurred after surgery.Serum alpha-fetoprotein(AFP),protein induced by vitamin K absence or antagonist-II(PIVIKA-II),maximum diameter of tumor,number of tumor and tumor vascularization patterns between the two groups were compared.Multivariate logistic regression analysis was performed to analyse the risk factors of TACE refractoriness in patients with HCC after TACE.Results The proportion of patients with AFP>400μg/L,PIVIKA-II>40 AU/L,number of tumor and tumor vascularization patternsⅢ+Ⅳ(uneven enhancement)were significantly higher in the TACE-refractory group than the control group(all P<0.05).The maximum diameter of tumor for patients in the TACE-refractory group was significantly larger than that in the control group(Z=-2.41,P=0.016).Multivariate logistic regression analysis showed that patients with serum AFP>400μg/L(OR=2.707,95%CI:1.008-7.271),multiple tumors(OR=6.069,95%CI:2.115-17.415)and tumor vascularization patternsⅢ+Ⅳ(uneven enhancement)(OR=7.813,95%CI:2.246-27.176)before the first TACE were at increased risks of TACE refractoriness(all P<0.05).Conclusion Preoperative AFP>400μg/L,multiple tumors and tumor vascularization patternsⅢ+Ⅳwere independent risk factors for TACE refractoriness in patients with HCC.
作者
潘智阳
许伟
祖茂衡
徐浩
王勇
李艳
王仲恺
徐肖杨
Pan Zhiyang;Xu Wei;Zu Maoheng;Xu Hao;Wang Yong;Li Yan;Wang Zhongkai;Xu Xiaoyang(Department of Interventional Radiology,the Affiliated Hospital of Xuzhou Medical University,Xuzhou 221006,China)
出处
《中华肝胆外科杂志》
CAS
CSCD
北大核心
2023年第1期34-37,共4页
Chinese Journal of Hepatobiliary Surgery
关键词
癌
肝细胞
化学栓塞
治疗性
危险因素
TACE抵抗
Carcinoma,hepatocellular
Chemoembolization,therapeutic
Risk factors
Transcatheter arterial chemoembolization refractoriness
作者简介
通信作者:许伟,Email:xuwei0202@qq.com。
