C-反应蛋白在原发性大肝癌患者肝动脉化疗栓塞前后变化规律及其临床意义  

Evaluation of Serum C reactive Protein as a Predictor of Prognosis in Transcatheter Arterial Chemoembolization for Large Hepatocellular Carcinoma

作　　者：史震山[1] 陈自谦[1] 杨熙章[1] 张鸿文[1] 庄大生[2] 

机构地区：[1]南京军区福州总医院医学影像中心介入病房,福州350025 [2]福建医科大学科研处,350004

出　　处：《临床放射学杂志》2009年第8期1138-1141,共4页Journal of Clinical Radiology

摘　　要：目的研究原发性大肝癌患者血清C-反应蛋白(C-reactive protein,CRP)在肝动脉化疗栓塞(TACE)前后变化规律及其临床意义。资料与方法回顾性分析2003年10月至2007年12月128例因原发性大肝癌行TACE患者的术前和术后1～8天血清CRP变化情况。52例术前CRP处于正常范围(阴性组),76例术前CRP高于正常值(阳性组)。随访观察治疗效果和患者生存率及复发率;利用散射免疫比浊法定量测定患者TACE前后血清中的CRP值。结果TACE后血清CRP浓度均在术后迅速增高,在术后4天达到峰值,以后逐渐降低,并于术后第8天下降到术前水平;CRP阴性组术后肿瘤体积缩小率高于阳性组,阴性组患者总生存率及有效肿瘤体积缩小率明显高于阳性组,复发率低于阳性组。结论TACE疗效与患者血清CRP变化呈负相关,TACE后CRP升高幅度大提示预后不良。TACE术前CRP可作为原发性大肝癌患者TACE后疗效及判断预后的参考指标。Objective To investigate the clinical significance of the serum C-reactive protein （CRP）in patients with large hepatocellular carcinoma （HCC） before and after transcatheter arterial chemoembolization （TACE）. Materials and Methods The values of serum CRP were quantitatively determined by immunoephelometry. Th one hundred and twentyeight patients with large HCC were retrospectively studied. 52 patients with the CRP level 〈 10ng/ml before TACE were served as the CRP-negative group,and 76 patients with the CRP level ≥ 10ng/ml before TACE were served as the CRP- positive group. Results Level of CRP increased after TACE and reached a peak on the 4th day in all patients, and then decreased. On the 8th day the CRP value reached the pre-TACE level. The overall survival and recurrence-free survival rates in the CRP-positive group were significantly lower than the rates in the CRP-negative group. The objective response rate in the CRP-positive group was significantly lower than which in the CRP-negative group after initial TACE. Conclusion The effect of TACE was inverse correlation with the CRP level and the extent of the increasement in the serum CRP after TACE indicates the poor outcome. CRP could be served as a reference to evaluate curative effect and prognosis for patients with large HCC.

关 键 词：C-反应蛋白 肝细胞癌 肝动脉化疗栓塞 预后 

分 类 号：R735.7[医药卫生—肿瘤]