DBIL/TBIL表达与超声引导下射频消融治疗原发性肝癌患者复发的关系  

Relationship Between DBIL/TBIL Expression and Recurrence of Ultrasound-GuidedRadiofrequency Ablation for Primary Carcinoma of Liver Patients

作　　者：杜轲锋[1] 邵亚丽 崔斌 DU Kefeng;SHAO Yali;CUI Bin(Department of Ultrasound,Luohe Central Hospital,Luohe 462000,China)

机构地区：[1]漯河市中心医院超声科,河南漯河462000

出　　处：《河南医学研究》2024年第5期922-925,共4页Henan Medical Research

摘　　要：目的分析血清直接胆红素(DBIL)/总胆红素(TBIL)比值与超声引导下射频消融治疗原发性肝癌(PLC)患者复发的关系。方法入选2018年3月至2021年2月124例拟行射频消融治疗的PLC患者作为研究对象,根据研究目的,在射频消融治疗前常规检测相关指标,包括血清DBIL、TBIL、肿瘤标志物及患者一般临床资料。以射频消融治疗达到完全消融视为消融成功,将消融治疗成功后2 a内复发视为随访终点,采用Cox回归,分析血清DBIL/TBIL与超声引导下射频消融治疗PLC患者复发的关系。结果2018年3月至2021年2月共收录124例PLC患者,一次消融成功率为92.06%(116/126),复发率为21.55%(25/116),射频消融治疗后复发患者肿瘤数目、肿瘤直径大于未复发患者,血清TBIL、DBIL低于未复发患者,甲胎蛋白、DBIL/TBIL比值高于未复发患者(P<0.05)。构建Cox回归分析显示,肿瘤数量≥3、瘤体直径、血清TBIL表达下调,DBIL/TBIL比值升高导致PLC患者射频消融治疗后复发风险增加(P<0.05)。绘制受试者工作特征曲线,血清DBIL/TBIL比值预测PLC患者射频消融治疗后复发的曲线下面积为0.776,当DBIL/TBIL截断值达到0.50时,可以获得最高敏感度(0.920)和特异度(0.495)。结论血清DBIL/TBIL比值升高导致PLC患者射频消融治疗后2 a内复发风险增加,消融治疗前计算DBIL/TBIL比值有助于预测复发风险。Objective To analyze the relationship between the ratio of direct bilirubin(DBIL)to total bilirubin(TBIL)in serum and the recurrence of patients with primary carcinoma of liver(PLC)treated with ultrasound guided radiofrequency ablation.Methods A total of 124 PLC patients who planned to undergo radiofrequency ablation treatment from March 2018 to February 2021 were selected as the research subjects.According to the research purpose,relevant indicators,including serum DBIL,TBIL,tumor markers,and general clinical data of the patients,were routinely tested before radiofrequency ablation treatment.Complete ablation of radiofrequency ablation was regarded as successful ablation,and recurrence within 2 years after successful ablation was regarded as the end point of follow-up.Cox regression was used to analyze the relationship between serum DBIL/TBIL and recurrence of ultrasound-guided radiofrequency ablation in patients with PLC.Results From March 2018 to February 2021,a total of 124 PLC patients were enrolled,with a one-time ablation success rate of 92.06%(116/126)and a recurrence rate of 21.55%(25/116).After radiofrequency ablation treatment,the number and diameter of tumors in recurrent patients were greater than those in non recurrent patients,while serum TBIL and DBIL were lower than those in non recurrent patients.The alpha fetoprotein and DBIL/TBIL ratio were higher than those in non recurrent patients(P<0.05).The construction of Cox regression analysis showed that the number of tumors≥3,tumor diameter,downregulation of serum TBIL expression,and an increase in DBIL/TBIL ratio led to an increased risk of recurrence in PLC patients after radiofrequency ablation treatment(P<0.05).Receiver operating characteristic curve was drawn.The area under the curve of serum DBIL/TBIL ratio to predict recurrence after radiofrequency ablation in PLC patients was 0.776.When the DBIL/TBIL cutoff value reached 0.50,the highest sensitivity(0.920)and specificity(0.495)could be obtained.Conclusion The increase in serum DBIL/TBIL rat

关 键 词：原发性肝癌 射频消融治疗 直接胆红素 总胆红素 复发 

分 类 号：R735.7[医药卫生—肿瘤]