γ-谷氨酰转肽酶和血小板比值对肝癌介入术后急性肝功能恶化的预测作用  

The value of gamma-glutamyl transpeptidase to platelet ratio index in predicting acute liver function deterioration after transarterial chemoembolization

作　　者：梅宝富 邓志锋 郑兰 林堆贤 MEI Bao-fu;DENG Zhi-feng;ZHENG Lan;LIN Dui-xian(The Bao′an District People′s Hospital,Shenzhen,Guangdong,China)

机构地区：[1]深圳宝安区人民医院,广东518000

出　　处：《肝脏》2021年第2期175-178,共4页Chinese Hepatology

基　　金：深圳宝安区科技计划社会公益项目(2015006)。

摘　　要：目的探讨γ-谷氨酰转肽酶和血小板比值指数(γ-glutamyl transpeptidase to platelet ratio index,GPRI)对原发性肝癌经导管动脉化疗栓塞(transcatheter arterial chemoembolization,TACE)术后发生急性肝功能恶化(acute liver function deterioration,ALFD)的预测作用。方法回顾性分析2015年6月至2019年12月接受TACE碘油栓塞治疗的141例肝癌临床资料,按文中标准分为ALFD组与对照组,对比两组患者的肝生化指标和GPRI,用ROC曲线和分层卡方检验分析GPRI指数对TACE术后ALFD的预测能力。结果ALFD组Child评分、GPRI指数明显高于对照组,差异有统计学意义。Child-Pugh评分、GPRI AUC分别为0.774、0.784,差异无统计学意义,最佳截点值分别为2.02、6。预测TACE术后ALFD的敏感度、特异度、阳性预测值(PPV)、阴性预测值(NPV)和正确率分别为0.735、0.785、0.521、0.903、0.779和0.588、0.888、0.606、0.870、0.808。分层分析显示,GPRI>2.02是ALFD的危险因素。结论GPRI对肝癌TACE术后ALFD风险具有一定预测价值,GPRI≤2.02可以安全接受TACE治疗,有助于筛选术后ALFD风险难以确定的Child-Pugh B级肝癌患者。Objective To investigate the value of gamma-glutamyl transpeptidase to platelet ratio index(GPRI)in predicting acute liver function deterioration(ALFD)in patients with primary liver cancer after transarterial chemoembolization(TACE).Methods The clinical data of 141 primary liver cancer patients treated with TACE in our hospital from June 2015 to December 2019 were retrospectively analyzed.The patients were divided into ALFD group and control group.The t test andχ^(2) test were used to compare the clinical data between 2 groups.The predictive value of Child-Pugh score and GPRI was assessed by receiver operating characteristic(ROC)curve.Results The Child-Pugh score and GPRI of ALFD group were significantly higher than those of control group.The area under the ROC curve(AUC)and cut-off value of Child-Pugh score were 0.774 and 6.The AUC of GPRI were 0.784 and 2.02.The sensitivity,specificity,positive predictive value(PPV),negative predictive value(NPV)and accuracy of Child-Pugh score were 58.8%,88.8%,60.6%,87.0%and 80.8%,respectively.The sensitivity,specificity,PPV,NPV and accuracy of GPRI were 73.5%,78.5%,52.1%,90.3%and 77.9%,respectively.GPRI>2.02 was risk factor for ALFD.Conclusion GPRI is valuable in predicting ALFD after TACE.It is safe to receive TACE when pre-operation GPRI≤2.02,which is helpful for evaluating the risk of ALFD in Child-Pugh B patients.

关 键 词：γ-谷氨酰转肽酶和血小板比值指数 肝癌 经导管动脉化疗栓塞术 急性肝功能恶化 

分 类 号：R73[医药卫生—肿瘤]