术前脱-γ-羧基凝血酶原在甲胎蛋白阴性肝细胞癌患者经导管动脉化疗栓塞术后疗效评价中的应用价值  

Application value of preoperative des-gamma-carboxy prothrombin in efficacy evaluation of alpha-fetoprotein-negative hepatocellular carcinoma after transarterial chemoembolization

作　　者：闵旭立 徐浩[1] 刘帆 杨林[1] 李强[2] 任勇军[1] MIN Xu-li;XU Hao;LIU Fan;YANG Lin;LI Qiang;REN Yong-jun(Department of Interventional Radiology,Affiliated Hospital of North Sichuan Medical College,Nanchong 637000,China;Department of Hepatobiliary Surgery,Affiliated Hospital of North Sichuan Medical College,Nanchong 637000,China)

机构地区：[1]川北医学院附属医院介入放射科,四川省南充市637000 [2]川北医学院附属医院肝胆外科,四川省南充市637000

出　　处：《广西医学》2020年第4期391-394,共4页Guangxi Medical Journal

基　　金：四川省教育厅科研计划(17ZB0169)。

摘　　要：目的探讨术前脱-γ-羧基凝血酶原(DCP)在甲胎蛋白阴性肝细胞癌患者经导管动脉化疗栓塞术(TACE)后疗效预测中的应用价值。方法检测104例甲胎蛋白阴性肝细胞癌患者TACE治疗前后的血清DCP水平。根据TACE术前血清DCP水平分为DCP≤50 mAU/mL组10例,50<DCP≤500 mAU/mL组46例,DCP>500 mAU/mL组48例。TACE术后30 d,分别检测各组血清DCP水平,并对术后疗效进行评价。结果术前肿瘤直径之和≤5 cm患者的血清DCP水平低于肿瘤直径大于>5 cm者(P<0.05);术前不同血清DCP水平组患者的肿瘤客观缓解率有统计学差异(P<0.05),其中DCP≤50 mAU/mL组患者的肿瘤客观缓解率最高;无反应组患者TACE术前及术后的血清DCP水平均高于反应组,反应组术后DCP水平较术前降低,而无反应组较术前升高(均P<0.05)。结论术前血清DCP水平与甲胎蛋白阴性肝细胞癌患者TACE术后预后密切相关,其水平越低,患者肿瘤缓解的概率越大,提示其在甲胎蛋白阴性肝癌患者TACE术后的疗效评价中具有潜在的临床应用价值。Objective To explore the application value of preoperative des-gamma-carboxy prothrombin(DCP)in the efficacy prediction of alpha-fetoprotein-negative hepatocellular carcinoma after transarterial chemoembolization(TACE).Methods Serum DCP level was measured in 104 patients with alpha-fetoprotein-negative hepatocellular carcinoma before and after TACE.And the patients were divided into DCP≤50 mAU/mL group(n=10),50<DCP≤500 mAU/mL group(n=46)and DCP>500 mAU/mL group(n=48)according to their serum DCP levels before TACE.Thirty days after TACE,serum DCP level was measured in each group,and the postoperative efficacy was evaluated.Results Patients with a sum of preoperative tumor diameters≤5cm had a lower serum DCP level than those with tumor diameter>5 cm(P<0.05).There was a statistically significant difference in objective response rate of tumor between patients with different preoperative serum DCP levels(P<0.05),with the highest objective response rate of tumor in the DCP≤50 mAU/mL group.The levels of serum DCP before and after TACE in the non-response group were higher than those in the response group.The postoperative DCP level was decreased in the response group but was elevated in the non-response group compared with the preoperative(all P<0.05).Conclusion preoperative serum DCP level is closely related to the prognosis of patients with alpha-fetoprotein-negative hepatocellular carcinoma after TACE,the lower the DCP level,the greater the probability of tumor remission in the patients,indicating that DCP has a potential clinical application value in the efficacy evaluation of alpha-fetoprotein-negative hepatocellular carcinoma after TACE.

关 键 词：脱-Γ-羧基凝血酶原 肝细胞癌 甲胎蛋白 阴性 经导管动脉化疗栓塞术 疗效评估 

分 类 号：R735.7[医药卫生—肿瘤]