阿帕替尼联合TACE治疗原发性肝癌复发生存的影响因素分析  被引量:9

Analysis of influencing factors on survival of apatinib combined with TACE in the treatment of hepatocellular carcinoma recurrence

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作  者:何翠瑛 苏贞栋 陈燕红[1] 周林荣[2] 杨宇 姚清深[2] HE Cui-ying;SU Zhen-dong;CHEN Yan-hong(Department of Oncology and Chemotherapy,Yulin Red Cross Hospital(Yulin Guangxi,537000),China)

机构地区:[1]玉林市红十字会医院肿瘤化疗科,广西玉林537000 [2]玉林市红十字会医院普通外科

出  处:《中西医结合肝病杂志》2023年第4期298-302,共5页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

基  金:广西壮族自治区卫生健康委科研基金项目(No.Z20200031)。

摘  要:目的:研究影响阿帕替尼联合肝动脉灌注化疗栓塞术(TACE)治疗原发性肝癌(PHC)复发患者生存的影响因素。方法:选择2015年6月到2020年12月到我院进行治疗的86例PHC术后肿瘤复发患者,采用阿帕替尼联合TACE进行治疗,对患者的年龄和性别,术前白蛋白(Alb)、总胆红素(TBil)、天门冬氨酸氨基转移酶(AST),丙氨酸氨基转移酶(ALT)和甲胎蛋白(AFP)水平等进行分析,患者临床资料主要包括肝炎史、肝硬化、有无酗酒、门静脉癌栓、肿瘤大小和数量、肝功能Child-Pugh分级和BCLC分期。通过门诊、邮件和电话等方式对患者进行随访,对肿瘤转移和复发以及患者死亡时间进行记录。结果:患者1年、2年、3年的生存率分别为48.84%、29.07%、9.30%,3年肿瘤转移复发率为8.14%。单因素分析显示,肿瘤直径、肝功能Child-Pugh分级、BCLC分期、门静脉癌栓、Alb、TBil、AST、ALT、AFP、肝硬化病史、性别是影响患者3年生存期的因素(P<0.05),肿瘤直径、BCLC分期、门静脉癌栓、Alb、TBil、AST、AFP、肝硬化病史和性别均是影响肿瘤复发转移的因素(P<0.05)。COX多因素分析显示,Child-Pugh分级B级、Alb、TBil、ALT、AFP和性别均为阿帕替尼联合TACE治疗肝癌患者3年生存期的独立危险因素(P<0.05);COX比例风险模型显示PHC患者肿瘤复发3年生存效能良好,AUC为0.92。BCLC分期B级、BCLC分级C级、门静脉癌栓、TBil水平升高和AFP均是PHC患者出现肿瘤复发转移的独立危险因素(P<0.05);COX比例风险模型预测PHC患者出现复发转移具有良好的效能,AUC为0.91。结论:阿帕替尼联合TACE治疗对PHC复发患者疗效显著,患者预后受多种因素影响,对治疗前相关因素进行评价,能够很好的进行预后评价。Objective:To study the influencing factors of apatinib combined with transcatheter arterial chemoembolization(TACE)on the survival of patients with recurrence of primary liver cancer.Methods:A total of 86 patients with primary liver cancer who had tumor recurrence after liver transplantation who came to our hospital from June 2015 to December 2020 were selected.The patients were treated with apatinib combined with TACE.The age and gender of the patients were selected.Preoperative Albumin(Alb),total bilirubin(TBil),aspartate aminotansferase(AST),alanine aminotransferase(ALT)and fetus The level of alpha-fetoprotein(AFP),etc.The clinical data of patients mainly include history of hepatitis,liver cirrhosis,alcohol abuse,portal vein tumor thrombus,tumor size and number,Child-Pugh classification of liver function,and BCLC staging.Follow-up of patients was proceed through outpatient clinics,emails and telephones to record tumor metastasis and recurrence,as well as the time of death of patients.Results:The 1-year,2-year and 3-year survival rates were 48.84%,29.07%and 9.30%,respectively.The 3-year tumor metastasis and recurrence rate was 8.14%.A univariate analysis showed that tumor diameter,Child-Pugh classification of liver function,BCLC staging,portal vein tumor thrombus,Alb,TBil,AST,ALT,AFP,history of liver cirrhosis,and gender were the factors affecting the patient's 3-year survival(P<0.05).Tumor diameter,BCLC stage,portal vein tumor thrombus,Alb,TBil,AST,AFP,historyof liver cirrhosis,and gender are all factors that affect tumor recurrence and metastasis(P<0.05).Cox multivariate analysis showed that elevated Alb levels and gender are protective factors for the 3-year survival of patients with liver cancer treated with apatinib combined with TACE(P>0.05).Child-Pugh grade B,elevated TBil,ALT and AFP are all the independent risk factors for the patient's 3-year survival(P<0.05).COX ratio risk model showed that patients with primary liver cancer who recurred after liver transplantation had a good 3-year survival efficien

关 键 词:阿帕替尼 肝动脉灌注化疗栓塞术 原发性肝癌 肝脏移植术 

分 类 号:R735.7[医药卫生—肿瘤]

 

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