AFP和MKP-1对无法切除的肝细胞癌患者经TACE术治疗的预后预测价值  

Prognostic value of AFP and MKP-1 in patients with unresectable hepatocellular carcinoma treated by TACE

作　　者：蔡越飞[1] 王凯 冼重杨 马燕华 柴克斌 CAI Yuefei;WANG Kai;XIAN Zhongyang;MA Yanhua;CHAI Kebin(Department of Intervention,Dongguan Donghua Hospital,Dongguan 523000,China)

机构地区：[1]东莞东华医院介入科,523000

出　　处：《国际消化病杂志》2021年第6期427-432,共6页International Journal of Digestive Diseases

基　　金：广东省医学科学技术研究基金(B2017104)。

摘　　要：目的探讨甲胎蛋白(AFP)、丝裂原激活蛋白激酶磷酸酶-1(MKP-1)对无法切除的肝细胞癌(HCC)患者接受经导管动脉化学治疗栓塞术(TACE)治疗后1年无进展生存率(PFS)和总生存率(OS)的预测价值。方法选择2016年1月至2018年12月在东莞东华医院介入科首次接受TACE治疗的197例无法切除的HCC患者作为研究对象,根据术前MKP-1基因表达情况和AFP水平进行分组,采用LSD-t检验或χ^(2)检验分别比较MKP-1阳性组与MKP-1阴性组及AFP≥400 ng/mL组与AFP<400 ng/mL组的临床病理特征,采用Kaplan-Meier生存分析分别比较MKP-1阳性组与MKP-1阴性组及AFP≥400 ng/mL组与AFP<400 ng/mL组在TACE术后1年的PFS和OS,采用Cox回归分析评价术前MKP-1基因表达状态和AFP水平对无法切除的HCC患者经TACE术治疗后1年的PFS和OS的影响。结果MKP-1阳性组与MKP-1阴性组、AFP≥400 ng/mL组与AFP<400 ng/mL组的临床病理特征差异均无统计学意义(P均>0.05)。Kaplan-Meier生存分析显示,MKP-1阴性组在TACE术后6、9、12个月的PFS和OS均显著低于MKP-1阳性组(80.6%、51.4%、42.3%比100.0%、85.6%、71.6%,90.7%、68.5%、52.9%比100.0%、100.0%、78.7%,P均<0.05)。AFP≥400 ng/mL组在TACE术后6、9、12个月的PFS和OS均显著低于AFP<400 ng/mL组(84.6%、57.6%、31.5%比100.0%、90.8%、58.4%,80.1%、52.7%、44.1%比100.0%、93.8%、81.9%,P均<0.05)。Cox回归分析显示,术前AFP水平和MKP-1基因表达均为HCC患者TACE术后1年PFS和OS的独立影响因素。结论术前AFP≥400 ng/mL、MKP-1基因表达阴性均预示无法切除的HCC患者经TACE术治疗后1年的PFS和OS较低,预后较差。Objective This paper intends to investigate the predictive value of alpha fetoprotein(AFP)and mitogen activated protein kinase phosphatase-1(MKP-1)in 1-year progression free survival rate(PFS)and the overall survival rate(OS)of unresectable hepatocellular carcinoma(HCC)patients after transcatheter arterial chemoembolization(TACE).Methods One hundred and ninety-seven patients with unresectable HCC who received TACE treatment for the first time in the Interventional Department of Dongguan Donghua Hospital from January 2016 to December 2018 were selected as the research objects.The patients were assigned to the MKP-1 positive group,the MKP-1 negative group,the AFP≥400 ng/mL group,and the AF P<400 ng/mL group based on the preoperative MKP-1 gene expression and the AFP level.LSD-t test orχ2 test were used to compare the clinicopathological characteristics between the MKP-1 positive group and the MKP-1 negative group,and between the AFP≥400 ng/mL group and the AF P<400 ng/mL group,respectively.Kaplan Meier survival analysis was used to compare PFS and OS of the MKP-1 positive group and the MKP-1 negative group,the AFP≥400 ng/mL group and the AF P<400 ng/mL group within 1 year after TACE.Cox regression analysis was used to evaluate the effects of preoperative MKP-1 gene expression status and the AFP level on PFS and OS in unresectable HCC patients within 1 year after TACE treatment.Results There is no significant difference in clinicopathological characteristics between the MKP-1 positive group and the MKP-1 negative group,the AFP≥400 ng/mL group and the AF P<400 ng/mL group(all P>0.05).The Kaplan-Meier survival analysis shows that the PFS and OS of the MKP-1 negative group at 6,9,and 12 months after TACE are significantly lower than those of the MKP-1 positive group(80.6%,51.4%,42.3%versus 100.0%,85.6%,71.6%,and 90.7%,68.5%,52.9%versus 100.0%,100.0%,78.7%,P<0.05).The PFS and OS of the AFP≥400 ng/mL group at 6,9,and 12 months after TACE are significantly lower than those of the AF P<400 ng/mL group(84.6%,57.6

关 键 词：无法切除的肝细胞癌 无进展生存率 总生存率 MKP-1基因表达 AFP 

分 类 号：R735.7[医药卫生—肿瘤]