血清PIVKA-Ⅱ和AFP-L3水平对肝细胞癌行TACE术后病情和预后评估的价值研究  

The value of PIVKA Ⅱ and serum AFP-L3 levels for evaluating the prognosis of primary liver cancer after TACE Therapy

作　　者：季琴 沈预程 邵春燕 JI Qin;SHEN Yu-chneg;SHAO Chun-yan(Hainan Peopled Hospital,Jiangsu 2266009,China)

机构地区：[1]海安市人民医院,江苏226600

出　　处：《肝脏》2022年第2期210-212,232,共4页Chinese Hepatology

基　　金：南通市2018年度市级科技计划项目(MSZ18192)。

摘　　要：目的 探讨血清异常凝血酶原(PIVKA-Ⅱ)和甲胎蛋白异质体3(AFP-L3)联合检测在肝细胞癌(HCC)经动脉化疗栓塞(TACE)术治疗后的临床应用价值。方法 选取63例行TACE的HCC患者,根据肝脏病灶直径变化分为缩小>50%亚组和<50%亚组,根据疗效分为完全缓解(CR)、部分缓解(PR)、疾病稳定(SD)和疾病进展(PD)亚组。分别检测血清PIVKA-Ⅱ和AFP-L3水平,并进行Pearson分析。结果 术后4周和术后8周的血清PIVKA-Ⅱ和AFP-L3水平低于手术前,且呈递减趋势(F=12.478,10.719,均P<0.05)。肝脏病灶直径缩小>50%亚组的血清PIVKA-Ⅱ和AFPL3水平低于<50%亚组(t=7.873,8.264,均P<0.05);CR组的血清PIVKA-Ⅱ和AFP-L3水平低于PR、SD和PD组,且呈递增趋势(F=15.682,9.825,均P<0.05)。经过Pearson相关分析,血清PIVKA-Ⅱ和AFP-L3水平联合检测的敏感度和特异度高于单项指标检测(87.61%,93.26%,均P<0.05)。结论 血清PIVKA-Ⅱ和AFP-L3水平联合检测对TACE术后HCC患者病情和预后评估具有较高的临床价值。Objective To investigate the clininal value of joint detection of abnormal serum prothrombin(PIVKA-Ⅱ)and AFP different plastid 3(AFP-L3)in patients with primary hepatocellular carcinoma(HCC)after conventional transcatheter arterial chemoembolization(TACE)therapy.Methods 63 HCC patients who underwent TACE were divided into>50% and<50% reduction subgroups according to the change of liver lesion size(in diameter),and into complete response(CR),partial response(PR),disease stability(SD)and disease progression(PD)subgroups according to the efficacy.Serum PIVKA-Ⅱand AFP-L3 levels was detected and analyzed with Pearson analysis.Results Serum PIVKA-Ⅱ and AFP-L3 levels at 4 weeks and 8 weeks after surgery were lower than those before surgery,and showed a decreasing trend(F=12.478,10.719,both P<0.05).Serum PIVKa-Ⅱand AFP-L3levels in>50%reduction subgroup were lower than those in<50%subgroup(t=7.873,8.264,all P<0.05).Serum PIVKa-Ⅱ and AFP-L3 levels in CR group were lower than those in PR,SD and PD groups,and showed an increasing trend in these groups,respectively(F=15.682,9.825,all P<0.05).After Pearson correlation analysis,the sensitivity and specificity of combined detection of serum PIVKa-Ⅱ and AFP-L3 levels were higher than those of single index detection(87.61% and 93.26%,both P<0.05).Conclusion A joint detection of PIVKA Ⅱand serum AFP-L3levels has high clinical value for evaluating the prognosis of HCC patients post TACE therapy.

关 键 词：肝细胞癌 经动脉化疗栓塞术 PIVKA-Ⅱ AFP-L3 

分 类 号：R735.7[医药卫生—肿瘤]