84例原发性肝癌患者肝动脉化疗栓塞术后预后的影响因素分析

目的 探讨原发性肝癌患者肝动脉化疗栓塞(TACE)术后预后影响因素及预后诊断指标的价值.方法 选取行TACE治疗的84例原发性肝癌患者,采用Cox风险比例模型分析患者的预后因素,另选取80例肝囊肿患者为对照组,采用酶联免疫吸附法测定两组患者的血清AFP、SCC、CYFRA21-1水平.结果 经Cox风险比例模型分析可知,门脉癌栓、肝内转移、Child-Pugh分级、AFP术后阳性、SCC术后阳性、CYFRA21-1术后阳性是原发性肝癌患者远期预后的独立危险因素.原发性肝癌组患者TACE术前、术后血清AFP、SCC、CYFRA21-1水平及AFP、SCC、CYFRA21-1阳性率均高于对照组,而TACE术后血清AFP、SCC、CYFRA21-1水平及AFP、SCC、CYFRA21-1阳性率低于TACE术前,差异均有统计学意义(P<0.05).结论 AFP术后阳性、SCC术后阳性、CYFRA21-1术后阳性是原发性肝癌患者TACE术后预后的独立危险因素,在预测原发性肝癌患者TACE术后预后方面具有潜在的临床价值.

Analysis of prognostic factors in 84 cases of primary hepatocellular carcinoma after treatment of transarterial chemoembolization

Objective To evaluate the prognostic factors of primary hepatocellular carcinoma (HCC) after the treat-ment of transarterial chemoembolization (TACE), and discuss the diagnostic value of prognostic indicators. Method 84 cases of primary HCC patients treated with TACE were enrolled in the study, and Cox proportional hazards model was ap-plied to analyze the prognostic factors, while another 80 cases of hepatic cysts were included as the control group. The se-rum levels of AFP, SCC, and CYFRA21-1 of the two groups were measured by enzyme-linked immunosorbent assay (ELISA) and compared. Result The Cox proportional hazards model analysis showed that, portal vein tumor thrombus, intrahepatic metastasis, Child-Pugh classification, positive AFP, SCC after surgery, and CYFRA21-1 after surgery were independent risk factors for primary HCC. The serum levels of serum AFP, SCC, CYFRA21-1 and positive rate of AFP, SCC, and CYFRA21-1 before and after TACE were higher than those in control group, and were lower after TACE com-pared with that before TACE (P<0.05). Conclusion Positive AFP, SCC, and CYFRA21-1 after surgery are independent risk factors for HCC, which are potentially effective in predicting the prognosis of HCC after TACE.