血清LDH的水平与肝癌介入治疗预后的关系  

Role of serum lactate dehydrogenase in prognosis of primary liver cancer in patients undergoing transarterial chemoembolization

作　　者：李金鹏[1] 石丛丛[2] 宋金龙[1] 陈华[1] 

机构地区：[1]山东省医学科学院山东省肿瘤医院外九科,济南市250117 [2]山东省精神卫生中心六病区

出　　处：《中国肿瘤临床》2013年第6期332-335,共4页Chinese Journal of Clinical Oncology

摘　　要：目的:探讨行TACE治疗肝癌患者血清乳酸脱氢酶水平与预后的关系。方法:分析山东省肿瘤医院2005年2月至2009年2月行肝动脉化疗栓塞术(transarterial chemoembolization,TACE)治疗的145例中晚期肝癌患者临床资料和实验室数据,分别于术前和术后1个月内监测乳酸脱氢酶的水平。结果:据术前血清乳酸脱氢酶浓度,将患者分为两组,对照组(LDH≤450 U/L)86例和观察组(LDH>450 U/L)59例。对照组平均疾病进展时间(TTP)和总生存期(OS)分别为14.2个月和19.3个月,观察组患者TTP和OS分别为9.1个月和11.2个月,两组患者TTP和OS差异有统计学意义(P<0.05)。治疗后64例患者LDH值下降,其TTP和OS分别为11.3和18.8个月,而术后81例患者LDH水平升高,其TTP和OS分别为9.1和9.8个月,两组患者TTP和OS差异有统计学意义(P<0.05)。结论:初诊患者血清乳酸脱氢酶活性检测能够预测行TACE肝癌患者的临床疗效,术前高LDH水平患者可能在TACE和抑制肿瘤血管生成的综合治疗方法中受益,可提高TTP和OS。Objective： This study aims to investigate the relationship between serum lactate dehydrogenase （LDH） levels and prognosis in the course of transarterial chemoembolization （TACE） of primary liver cancer （PLC）. Methods： Clinical and laboratory da- ta of 145 consecutive patients undergoing trans-arterial chemo-embolization of unresectable PLC from February 2005 to February 2009 were analyzed. LDH values were obtained from the patients a month before the procedure. Results： The patients were divided into two groups according to the concentration of the LDH serum registered before TACE （first： LDH〈450, U/L 86 patients; second： LDH〉450, U/L 59 patients）. The patients were also classified according to the variation in the LDH serum levels before and after treatment （in- creased： 81 patients versus decreased： 64 patients）. The median time to progression （TTP） was 14.2 months for patients with LDH val- ues below 450 U/L, whereas median TTP was 9.1 months for patients with LDH values above the cut-off （P=0.000）. The median over- all survival （OS） was 19.3 months and l 1.2 months （P=0.000）. Median TTP was 11.3 months and median OS was 18.8 months for pa- tients with decreased LDH values after treatment, whereas median TTP was 9.1 months and median OS was 9.8 months for patients with increased LDH levels （TTP： P=-0.001; OS： P=0.004）. Conclusions： LDH is able to predict the clinical outcome for HCC patients undergoing TACE. High LDH pretreatment levels may be suitable candidates for clinical exploration in a multimodality treatment ap- proach with TACE and anti-VEGF inhibitors to improve TTP and OS.

关 键 词：原发性肝癌乳酸脱氢酶动脉化疗栓塞术预后 生存期 

分 类 号：R735.7[医药卫生—肿瘤]