摘要
目的探讨残肝体积(RLV)在预测原发性肝癌(HCC)患者经肝动脉化疗栓塞(TACE)术后肝功能损伤及生存期评估中的应用价值。方法回顾性分析江南大学附属医院2014年3月至2018年4月经TACE治疗的中国肝癌分期方案(CNLC)Ⅰb~Ⅱb期HCC患者的临床影像资料,入选160例。利用CT容积法测量TACE前RLV和肿瘤体积(TV),用体表面积(BSA)标准化后计算标准化后的残肝体积(RLV_(BSA))。根据受试者工作特征(ROC)曲线截断值对RLV_(BSA)进行分组。结合Child-Pugh和ALBI评分,行Logistic回归分析评估各参数与肝功能之间的相关及独立危险因素;行生存分析评估患者生存预后。结果RLV_(BSA)预测TACE术后肝功能损伤的截断值为559 cm3。单因素和多因素分析显示RLV_(BSA)是预测肝功能损伤的独立危险因素。大RLV_(BSA)组(RLV_(BSA)>559 cm^(3))患者的中位总生存期(OS)为31个月(95%CI:29,33),小RLV_(BSA)组(RLV_(BSA)≤559 cm^(3))患者的中位OS为17个月(95%CI:11,23)(P<0.001)。160例患者中位OS 28个月(95%CI:26,30),其中52例(32.5%)在术后30~90天发生肝功能损伤。结论小RLV_(BSA)与HCC患者TACE术后慢性肝功能损伤、生存期降低呈正相关关系。
Objective To evaluate the value of residual liver volume in predicting liver dysfunction and prognosis in patients with hepatocellular carcinoma(HCC)post-transcatheter arterial chemoembolization(TACE).Methods Retrospective analysis of 160 patients with China liver cancer stagingⅠb-Ⅱb HCC,who were treated with TACE from March2014 to April 2018.The residual liver volume(RLV)pre-TACE were assessed using CT volumetry and normalized to body surface area(BSA)to yield RLV_(BSA).The cutoff value of Receiver operating characteristic(ROC)curve was used for RLV_(BSA)stratification.Logistic regression analysis was performed to determine the risk factors of liver dysfunction.Survival prognosis were calculated using Kaplan-Meier curve.Results The cutoff value of RLV_(BSA)for predicting liver dysfunction post-TACE was 559 cm3.Univariate and multivariate analyses showed that RLV_(BSA)was an independent risk factor for predicting liver dysfunction.The median overall survival of patients with a RLV(BSN)>559 cm^(3) was 31(95%CI:29,33)months,while that of patients with a RLV_(BSA)≤559cm^(3) was 17(95%CI:11,23)months(P<0.002).At a median overall survival of 28(95%CI:26,30)months,52 patients were diagnosed with hepatic dysfunction post-TACE.Conclusion A smaller RLV_(BSA)is positively associated with chronic liver dysfunction and reduced overall survival.
作者
黄虹
吴清华
姜建威
吴勇
严俭
乔红艳
HUANG Hong;WU Qinghua;JIANG Jianwei(Department of Radiology,Affiliated Hospital of Jiangnan University,Wuxi,Jiangsu Province 214062,P.R.China)
出处
《临床放射学杂志》
北大核心
2023年第10期1596-1601,共6页
Journal of Clinical Radiology
基金
无锡市卫计委科研重大项目(编号:ZDRCPY010)
无锡市卫健委妇幼科研面上项目(编号:FYKY201902)
太湖高层次人才项目(编号:J2020048)
无锡市卫生健康委科研项目面上项目(编号:M202226)。
作者简介
通讯作者:吴清华;通讯作者:乔红艳。
