AFP在肝癌免疫治疗中的临床预测价值  

The predictive value of AFP in immunotherapy of liver cancer

作　　者：于梦媛 乔丽丽 张建东[1,2] YU Meng-yuan;QIAOLi-li;ZHANG Jian-dong(Shandong University,Shandong Jinan 250000)

机构地区：[1]山东大学,山东济南250000 [2]山东第一医科大学第一附属医院(山东省千佛山医院)肿瘤放疗科,山东济南250014

出　　处：《医学检验与临床》2024年第9期15-19,共5页Medical Laboratory Science and Clinics

摘　　要：目的:分析甲胎蛋白(AFP)在肝癌免疫治疗中的临床预测价值,为患者结局预测和免疫治疗效果评价提供理论依据。方法:统计2007年4月-2023年7月在我院接受免疫治疗的肝癌患者,绘制基线资料表。根据免疫治疗前最近一次AFP表达水平和患者生存期绘制KM曲线,分析AFP的临床预后价值。以AFP值<100ng/mL、100~10000ng/mL、≥10000ng/mL分为三组,统计不同组别患者在免疫治疗后的进展情况(进展部位、数量等),分析AFP对肝癌患者免疫治疗后进展的预测能力。结果:AFP低于400ng/mL的肝癌患者组在免疫治疗后有更长的无进展生存期(PFS)和总生存期(OS);AFP(100~10000ng/mL)组内的患者发生免疫抵抗的比率最高;AFP(100~10000ng/mL)组免疫治疗后最常见的进展部位为肺,AFP<100ng/mL及>10000ng/mL组最常见的进展部位为肝(原发灶增大或肝内新发病灶)。结论:肝癌患者免疫治疗前AFP表达水平对免疫治疗患者生存期和肿瘤进展有良好的预测价值,可作为临床治疗方法选择的重要参考依据。Objective:To analyze the clinical predictive value of alpha-fetoprotein(AFP)in liver cancer immunotherapy,and to provide theoretical basis for patient outcome prediction and immunotherapy effect evaluation.Methods:The patients with liver cancer who received immunotherapy in our hospital from April 2007 to July 2019 were counted and the baseline data table was drawn.According to the last AFP expression level and survival time of patients before immunotherapy,the KM curve was drawn to analyze the clinical prognostic value of AFP.The AFP values of<100ng/mL,100-~10000 ng/mL,and>10000 ng/mL were divided into three groups.The progression of patients in different groups after immunotherapy was statistically analyzed(site and quantity of progression,etc.),and the predictive ability of AFP for progression of liver cancer patients after immunotherapy was analyzed.Results:HCC patients with AFP less than 400 ng/mL had longer progression-free survival(PFS)and overall survival(OS)after immunotherapy.Patients in the AFP(100~10000 ng/mL)group had the highest rate of immune resistance.The most common site of progression afer immunotherapy for AFP(100-10000 ng/mL)group was lung,and the most common site of progression for AFP<100 ng/mL and≥>10000 ng/mL group was liver(enlargement of the primary site or new lesions in the liver).Conclusion:AFP expression level before immunotherapy has a good predictive value for survival and tumor progression of patients with liver cancer,and can be used as an important reference for clinical treatment.

关 键 词：肝癌 免疫治疗 AFP 免疫抵抗 预测价值 

分 类 号：R735.7[医药卫生—肿瘤]