CT动脉增强分数、甲胎蛋白异质体3、中性粒细胞与淋巴细胞比值联合检测对肝癌患者介入化疗疗效的评估价值  

Value of CT arterial enhancement fraction,alpha-fetoprotein variant 3,and neutrophil-lymphocyte ratio combined detection in evaluating the efficacy of interventional chemotherapy for liver cancer patients

作　　者：王兴龙[1] 冯坤鹏[1] 袁牧[1] 孟令武[2] WANG Xinglong;FENG Kunpeng;YUAN Mu;MENG Lingwu(CT Room,the First People’s Hospital of Shangqiu,Shangqiu 476100,He’nan,China;Department of Intervention,the First People’s Hospital of Shangqiu,Shangqiu 476100,He’nan,China)

机构地区：[1]商丘市第一人民医院CT室,河南商丘4761000 [2]商丘市第一人民医院介入科,河南商丘4761000

出　　处：《癌症进展》2024年第10期1146-1150,共5页Oncology Progress

摘　　要：目的 探讨CT动脉增强分数(AEF)、甲胎蛋白异质体3(AFP-L3)、中性粒细胞与淋巴细胞比值(NLR)联合检测对肝癌患者介入化疗疗效的评估价值。方法 选取94例肝癌介入化疗患者,所有患者均于术前1天、术后30天行CT增强扫描,并检测AFP-L3、中性粒细胞计数和淋巴细胞计数。根据临床疗效将患者分为治疗有效组[完全缓解(CR)+部分缓解(PR)]和治疗无效组[疾病稳定(SD)+疾病进展(PD)],比较两组患者的临床资料,采用Logistic回归模型分析肝癌患者介入化疗疗效的影响因素。绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC),分析AEF、AFP-L3、NLR单独及联合检测对肝癌患者介入化疗疗效的评估价值。结果 94例肝癌患者中,治疗有效组37例(CR 10例,PR 27例),治疗无效组57例(SD 34例,PD 23例)。治疗有效组中肿瘤直径﹤5 cm、肿瘤数目为单发、TNM分期为Ⅱb期的患者比例均高于治疗无效组,差异均有统计学意义(P﹤0.05);治疗有效组患者术后30天AEF、AFP-L3、NLR均明显低于治疗无效组,差异均有统计学意义(P﹤0.01)。多因素Logistic回归分析结果显示,术后30天AEF、AFP-L3、NLR较高均是肝癌患者介入化疗疗效的独立危险因素(P﹤0.05)。ROC曲线显示,AEF、AFP-L3、NLR联合检测评估肝癌患者介入化疗疗效的AUC为0.963,灵敏度为92.98%,均高于各指标单独检测。结论 术后30天AEF、AFP-L3、NLR较高均是肝癌患者介入化疗疗效的独立危险因素,三者联合检测可有效评估肝癌患者介入化疗疗效,为后续治疗提供参考。Objective To explore the value of CT arterial enhancement fraction(AEF),alpha-fetoprotein variant 3(AFP-L3),and neutrophil-lymphocyte ratio(NLR)combined detection in evaluating the efficacy of interventional chemo-therapy for liver cancer patients.Method A total of 94 liver cancer patients who underwent interventional chemotherapy were selected.One day before surgery and thirty days after surgery,all patients received enhanced CT scan,and AFP-L3,neutrophil count and lymphocyte count were detected.According to clinical efficacy,the patients were divided into effec-tive treatment group[complete response(CR)+partial response(PR)]and ineffective treatment group[stable disease(SD)+progressive disease(PD)],and the clinical data of the two groups were compared.Logistic regression model was used to analyze the factors influencing the clinical efficacy of interventional chemotherapy for liver cancer patients.The receiver operating characteristic(ROC)curve was plotted,the area under the curve(AUC)was calculated,and the value of AEF,AFP-L3 and NLR single and combined detection in evaluating the efficacy of interventional chemotherapy for liver cancer patients were analyzed.Result Among 94 liver cancer patients,37 cases were in the effective treatment group(10 cases of CR,27 cases of PR)and 57 cases were in the ineffective treatment group(34 cases of SD,23 cases of PD).The proportion of patients with tumor diameter<5 cm,single tumor and TNM stage IIb in the effective treatment group were higher than those in the ineffective treatment group,and the differences were statistically significant(P<0.05).The AEF,AFP-L3 and NLR at 30 days after surgery in the effective treatment group were significantly lower than those in the ineffective treatment group,and the differences were statistically significant(P<0.01).Multivariate Logistic re-gression analysis showed that higher AEF,AFP-L3 and NLR at 30 days after surgery were independent risk factors for the efficacy of interventional chemotherapy in liver cancer patients(P<0.05).ROC cur

关 键 词：CT动脉增强分数 甲胎蛋白异质体3 中性粒细胞与淋巴细胞比值 肝癌 介入化疗 疗效 

分 类 号：R735.7[医药卫生—肿瘤]