AST/ALT、白蛋白与肝癌患者病理特征及TACE治疗预后的关系  

Relationship of AST/ALT and albumin with pathological features and prognosis of TACE in patients with liver cancer

作　　者：张超 柏祥云 薛凤华 ZHANG Chao;BAI Xiangyun;XUE Fenghua(Department of Intervention,Linyi Cancer Hospital,Linyi,Shandong,China,276000;Department of Thoracic Surgery,Linyi Cancer Hospital,Linyi,Shandong,China,276000)

机构地区：[1]临沂市肿瘤医院介入科,山东临沂276000 [2]临沂市肿瘤医院胸外科,山东临沂276000

出　　处：《分子诊断与治疗杂志》2024年第5期930-934,共5页Journal of Molecular Diagnostics and Therapy

基　　金：山东省临沂市科技发展计划项目(202120025)。

摘　　要：目的 探究谷草转氨酶(AST)/谷丙转氨酶(ALT)、白蛋白与肝癌患者病理特征及经动脉化疗栓塞(TACE)治疗预后的关系。方法 选取2018年8月至2022年8月于临沂市肿瘤医院行TACE治疗的肝癌患者168例,据术后1年生存情况,将患者分为预后不良组27例和预后良好组141例,比较不同病理特征患者术前AST/ALT、白蛋白水平,比较不同预后TACE术后肝癌患者病理特征,比较不同预后TACE术后肝癌患者AST/ALT、白蛋白水平,采用ROC曲线分析其对肝癌患者TACE治疗预后的预测价值,采用Logistics二元回归方程分析AST/ALT、白蛋白对肝癌TACE治疗患者预后的影响作用。结果 年龄≥60岁、Child-Pugh B级、HbsAg阳性、肿瘤直径>5 cm、肿瘤多发、肿瘤分期更高、肿瘤低分化肝癌患者术前AST/ALT更高,术前白蛋白水平更低,差异均有统计学意义(P<0.05);两组年龄、HbsAg情况、肿瘤直径、肿瘤数量、肿瘤分期、分化程度比较差异均有统计学意义(P<0.05);预后良好组术前、术后AST/ALT低于预后不良组,术前、术后白蛋白水平高于预后不良组,差异有统计学意义(P<0.05);ROC结果显示,术前、术后的AST/ALT、白蛋白预测肝癌患者TACE治疗预后的AUC分别为0.887、0.787、0.854、0.580,联合预测的AUC为0.914(P<0.05);Logistic回归分析结果显示,年龄≥60岁、肿瘤直径>5 cm、肿瘤多发、肿瘤分期为Ⅲa期、肿瘤低分化、术前AST/ALT>1.82、术前白蛋白<33.21 g/L、术后AST/ALT>1.83、术后白蛋白<43.96 g/L均为肝癌患者TACE治疗预后不良的影响因素(P<0.05)。结论 AST/ALT、白蛋白水平在不同病理特征肝癌患者中具有差异性,具有预测TACE治疗预后的作用。Objective To explore the relationship of aspartate aminotransferase(AST)/alanine aminotransferase(ALT)and albumin with pathological features and prognosis of transarterial chemoemboliza⁃tion(TACE)in patients with liver cancer.Methods 168 patients with liver cancer who received TACE treat⁃ment at Linyi Cancer Hospital from August 2018 to August 2022 were selected.Based on their survival status one year after surgery,the patients were divided into two groups:those with a good prognosis(27 cases)and those with a poor prognosis(141 cases).The study aimed to compare the differences in AST/ALT levels and albumin levels among patients who underwent TACE with different pathological features.To compare the path⁃ological characteristics,AST/ALT levels,and albumin levels of patients with hepatocellular carcinoma after TACE with different prognoses.ROC curve analysis was used to determine the predictive value of the above indicators on the prognosis of TACE in patients with liver cancer.Logistic binary regression equations were ap⁃plied to analyze the influence of AST/ALT and albumin on the prognosis of patients with liver cancer undergo⁃ing TACE.Results The preoperative AST/ALT levels were higher,while the preoperative albumin levels were lower among patients aged≥60 years old,with Child⁃Pugh grade B,positive HbsAg,tumor diameter>5 cm,multiple tumors,high tumor stage,and low tumor differentiation(P<0.05).There were statistically sig⁃nificant differences in age,HbsAg status,tumor diameter,quantity,staging,and differentiation degree be⁃tween the two groups(P<0.05).The preoperative and postoperative AST/ALT in good prognosis group were lower while the preoperative and postoperative albumin levels were higher than those levels in the poor progno⁃sis group(P<0.05).ROC results showed that the AUCs of preoperative and postoperative AST/ALT and albu⁃min independently in predicting the prognosis of TACE in patients with liver cancer were 0.887,0.787,0.854 and 0.580 respectively,and the AUC of combined predictio

关 键 词：肝癌 经动脉化疗栓塞 谷丙转氨酶/谷草转氨酶 白蛋白 

分 类 号：R735.7[医药卫生—肿瘤]