脱-γ-羧基凝血酶原对原发性肝癌TACE术后复发转移的预测价值  

Predictive value of des-gamma-carboxy prothrombin in the recurrent metastasis after transarterial chemoembolization of primary liver cancer

作　　者：汪亚丽[1] 郑茂 果基牛牛 许丹[1] WANG Yali;ZHENG Mao;GUOJI Niuniu(Department of Laboratory,Deyang People’s Hospital,Sichuan,Deyang 618000,China)

机构地区：[1]四川省德阳市人民医院检验科,618000

出　　处：《河北医药》2024年第20期3070-3074,共5页Hebei Medical Journal

基　　金：四川省基层卫生事业发展研究中心科研项目(编号:SWFZ19-Y-37)。

摘　　要：目的探讨脱-γ-羧基凝血酶原(des-gamma-carboxy prothrombin,DCP)对原发性肝癌TACE术后复发转移的预测价值。方法收集2019年8月至2021年8月接受以TACE为初始治疗的150例原发性肝癌患者临床资料。采用单因素和多因素Cox回归分析TACE术后复发转移的危险因素,利用受试者工作特征(ROC)曲线评价血清DCP对肿瘤复发转移的预测价值,Kaplan-Meier法分析不同DCP水平患者无瘤生存情况。结果单因素分析显示,年龄、最大癌结节直径、肿瘤数目、AST、ALB、TBIL、AFP、DCP与原发性肝癌TACE术后复发转移有关(均P<0.05);多因素Cox回归分析显示,年龄、肿瘤数目、TBIL、DCP是原发性肝癌TACE术后复发转移的独立危险因素(P<0.05)。血清DCP预测TACE术后复发转移的曲线下面积为0.782,最佳临界值为280.00 mAU/mL,特异度为53.13%,敏感度为88.89%。以最佳临界值分组进行生存分析,DCP高水平组无瘤生存率低于DCP低水平组,差异有统计学意义(Log-Rankχ^(2)=4.845,P=0.028)。结论血清DCP对原发性肝癌TACE术后复发转移有一定预测价值,当患者TACE治疗前血清DCP>280.00 mAU/mL时,术后肿瘤复发率较高。Objective To investigate the predictive value of des-gamma-carboxy prothrombin(DCP)in the recurrent metastasis after transarterial chemoembolization(TACE)in primary liver cancer patients.Methods Totally,clinical data of 150 primary liver cancer patients initially treated with TACE were collected from August 2019 to August 2021 in the Deyang People`s Hospital.The risk factors for recurrent metastasis was analyzed by univariate and multivariate Cox regression.The predictive value of serum DCP in the recurrent metastasis of primary liver cancer after TACE was assessed by receiver operating characteristic(ROC)analysis.The tumor-free survival was evaluated by Kaplan-Meier survival analysis.Results Univariate Cox regression showed that age,tumor maximal diameter,tumor number,aspartate transaminase(AST),albumin(ALB),total bilirubin(TBIL),alpha-fetoprotein(AFP),and DCP were significantly associated with recurrent metastasis of primary liver cancer after TACE(all P<0.05).Multivariate analysis indicated that age,tumor number,TBIL,and DCP were independent risk factors for recurrent metastasis of primary liver cancer after TACE(P<0.05).The area under the curve(AUC)of DCP in predicting recurrent metastasis of primary liver cancer was 0.782,with the optimal cutoff value of 280.00mAU/mL,specificity of 53.13%and sensitivity of 88.89%.Survival analysis was performed using a DCP cutoff value of 280.00mAU/mL,and the tumor-free survival in the high-level DCP group was significantly lower than that of the low-level DCP group(Log-Rankχ^(2)=4.845,P=0.028).Conclusion Serum DCP offers a predictive value recurrent metastasis of primary liver cancer after TACE.Primary liver cancer patients with a pre-TACE serum DCP>280.00mAU/mL suffer from a high tumor recurrent rate after TACE.

关 键 词：原发性肝癌 经动脉化疗栓塞 脱-Γ-羧基凝血酶原 复发 

分 类 号：R735.7[医药卫生—肿瘤]