经导管动脉化疗栓塞术同步联合选择性门静脉栓塞术对大肝癌手术患者血清肿瘤标志物及预后的影响研究  

Effect of TACE Combined with SPVE on Serum Tumor Markers and Prog⁃nosis of Patients with Large Liver Cancer

作　　者：罗静 杨秦 LUO Jing;YANG Qin(Department of Oncologic Medicine,Meishan Second People's Hospital,Meishan,Sichuan 620500,China)

机构地区：[1]眉山市第二人民医院肿瘤内科,四川眉山620500

出　　处：《转化医学杂志》2024年第7期1000-1004,共5页Translational Medicine Journal

摘　　要：目的探讨经导管动脉化疗栓塞术(TACE)同步联合选择性门静脉栓塞(SPVE)对大肝癌手术患者血清肿瘤标志物、预后的影响。方法回顾性选取2020年6月至2023年1月眉山市第二人民医院收治的大肝癌手术患者110例,根据治疗方式分成A组(58例)与B组(52例)。A组于TACE同步联合SPVE术后行大肝癌手术,B组于TACE后行大肝癌手术。比较2组治疗前后的残余肝体积、残肝比及血清α-L-岩藻糖苷酶(AFu)、癌胚抗原(CEA)、甲胎蛋白(AFP)水平。以患者入院当日为随访起始日,以2023年6月30日为随访截止日,比较2组远期生存情况。利用Cox风险回归模型分析患者预后影响因素。结果治疗后,2组残余肝体积、残肝比高于治疗前,且A组高于B组,差异有统计学意义(P<0.05)。治疗后,2组AFu、CEA、AFP低于治疗前,且A组低于B组,差异有统计学意义(P<0.05)。A组中位生存期长于B组,总体生存率高于B组,且A组平均生存期高于B组(P<0.05)。Cox风险回归分析结果显示,肿瘤直径、包膜完整、分化程度、肝硬化、术前TACE+SPVE治疗是大肝癌手术患者预后的影响因素(P<0.05)。结论TACE联合SPVE能更有效降低大肝癌手术患者的AFu、CEA、AFP水平,改善远期预后,除肿瘤直径、包膜完整、分化程度、肝硬化外,术前TACE+SPVE治疗也是大肝癌手术患者预后的影响因素。Objective To investigate the effects of transcatheter arterial chemoembolization(TACE)combined with selective portal vein embolization(SPVE)on serum tumor markers and prognosis of patients undergoing surgery for large liver cancer.Methods A retrospective study was conducted to select 110 patients with large liver cancer who underwent surgery in Meishan second people's hospital from June 2020 to January 2023,and were divided into group A(n=58)and group B(n=52)according to treatment methods.Group A underwent surgery for large liver cancer after TACE and SPVE,group B under⁃went surgery for large liver cancer after TACE.The residual liver volume,residual liver ratio and serumα⁃L⁃fucosidase(AFu),carcinoembryonic antigen(CEA)and alpha⁃fetoprotein(AFP)levels were compared between the two groups before and after treatment.With the date of admission as the start date of follow⁃up and June 30,2023 as the end date of follow⁃up,the long⁃term survival of the two groups was compared.Cox risk regression model was used to analyze the prognostic factors.Results After treatment,the residual liver volume and residual liver ratio in 2 groups were higher than before treatment,and group A was higher than group B(P<0.05).AFu,CEA and AFP in 2 groups were lower after treatment than before treat⁃ment,and group A was lower than group B(P<0.05).The median survival time of group A was longer than that of group B,the overall survival rate was higher than that of group B,and the average survival time of group A was higher than that of group B(P<0.05).Cox risk regression analysis suggested that tumor diameter,capsule integrity,degree of differentiation,cirrho⁃sis,and preoperative TACE+SPVE treatment were the prognostic factors of patients with large liver cancer after surgery(P<0.05).Conclusion TACE combined with SPVE can more effectively reduce the levels of AFu,CEA and AFP in patients undergoing surgery for large liver cancer,and improve the long⁃term prognosis.In addition to tumor diameter,capsule integri⁃ty,degree of

关 键 词：经导管动脉化疗栓塞术 选择性门静脉栓塞 肿瘤标志物 预后 

分 类 号：R735.7[医药卫生—肿瘤]