NLR、TNF-α水平对巨块型肝癌患者TACE联合微波消融治疗效果的预测分析  

Predictive analysis of NLR and TNF-αlevel for the efficacy of TACE combined with microwave ablation therapy in patients with massive liver cancer

作　　者：邢辉[1] 谭莹 王秀珍 李瑞 刘霞[1] Xing Hui;Tan Ying;Wang Xiuzhen;Li Rui;Liu Xia(Center of Interventional Vascular Surgery,Affiliated Hospital of Weifang Medical University,Weifang 261000,China)

机构地区：[1]潍坊医学院附属医院介入血管外科中心,潍坊261000

出　　处：《国际肿瘤学杂志》2025年第2期101-106,共6页Journal of International Oncology

基　　金：潍坊市卫生健康委员会科研项目(WFWSJK-2022-169)。

摘　　要：目的探讨中性粒细胞与淋巴细胞比值(NLR)、肿瘤坏死因子-α(TNF-α)水平对巨块型肝癌患者经动脉化疗栓塞术(TACE)联合微波消融治疗效果的预测价值。方法回顾性分析2020年2月—2023年2月潍坊医学院附属医院行TACE联合微波消融治疗的106例巨块型肝癌患者病历资料,术后6周评估疗效,根据治疗效果将患者分为缓解组、未缓解组。分别于术前、术后3 d和术后7 d检测两组NLR、TNF-α水平,采用点二列相关性分析不同时间段NLR、TNF-α水平与巨块型肝癌患者TACE联合微波消融治疗效果的关系,绘制受试者操作特征(ROC)曲线分析不同时间段NLR、TNF-α水平对巨块型肝癌患者TACE联合微波消融治疗效果的预测价值。结果术后6周,106例巨块型肝癌患者中完全缓解13例,部分缓解48例,疾病进展20例,病情稳定25例,总缓解率为57.55%(61/106)。术前,缓解组(n=61)NLR[(2.26±0.13)比(2.43±0.12),t=6.87,P<0.001]、TNF-α水平[(36.20±4.38)pg/ml比(42.74±5.74)pg/ml,t=6.66,P<0.001]均低于未缓解组(n=45),差异有统计学意义;术后3 d,缓解组与未缓解组NLR[(6.16±3.22)比(6.22±3.30),t=0.09,P=0.925]、TNF-α水平[(48.84±7.22)pg/ml比(49.13±7.34)pg/ml,t=0.20,P=0.840]比较,差异均无统计学意义;术后7 d,缓解组NLR[(2.60±0.18)比(2.82±0.26),t=5.15,P<0.001]、TNF-α水平[(38.20±6.30)pg/ml比(45.57±5.79)pg/ml,t=6.16,P<0.001]均低于未缓解组,差异均有统计学意义。缓解组与未缓解组术前、术后3 d、术后7 d的NLR、TNF-α水平差异均有统计学意义(F=82.43,P<0.001;F=54.45,P<0.001;F=76.23,P<0.001;F=15.61,P<0.001)。进一步两两比较发现,与术前相比,两组术后3 d、术后7 d的NLR、TNF-α水平均更高,但两组术后7 d NLR、TNF-α水平均低于术后3 d,差异均有统计学意义(均P<0.05)。点二列相关性分析显示,术前及术后7 d NLR、TNF-α水平与巨块型肝癌患者TACE联合微波消融治疗效果均呈现出显著正相关(r=0.42,P<0.001;r=0.49,P<0.00Objective To explore the predictive value of neutrophil-to-lymphocyte ratio(NLR)and tumor necrosis factor-α(TNF-α)level on the therapeutic effect of transcatheter arterial chemoembolization(TACE)combined with microwave ablation in patients with massive liver cancer.Methods The medical records of 106 patients with massive liver cancer who underwent TACE combined with microwave ablation treatment in the Affiliated Hospital of Weifang Medical University from February 2020 to February 2023 were retrospectively analyzed.The efficacy was evaluated 6 weeks after surgery,and the patients were divided into remission group and non-remission group according to the therapeutic effect.The levels of NLR and TNF-αin the two groups were detected before surgery,3 days after surgery and 7 days after surgery.Point two column correlation was used to analyze the relationship between the levels of NLR and TNF-αin different time periods and the therapeutic effect of TACE combined with microwave ablation in patients with massive liver cancer.The receiver operator characteristic(ROC)curve was drawn to analyze the predictive value of NLR and TNF-αlevels in different time periods for the therapeutic effect of TACE combined with microwave ablation in patients with massive liver cancer.Results Six weeks after surgery,out of 106 patients with massive liver cancer,13 achieved complete remission,48 achieved partial remission,20 experienced disease progression,and 25 remained stable.The overall remission rate was 57.55%(61/106).Before surgery,the levels of NLR[(2.26±0.13)vs.(2.43±0.12),t=6.87,P<0.001]and TNF-α[(36.20±4.38)pg/ml vs.(42.74±5.74)pg/ml,t=6.66,P<0.001]in the remission group(n=61)were lower than those in the non-remission group(n=45),with statistically significant differences.At 3 days after surgery,there were no statistically significant difference in the levels of NLR[(6.16±3.22)vs.(6.22±3.30),t=0.09,P=0.925]or TNF-α[(48.84±7.22)pg/ml vs.(49.13±7.34)pg/ml,t=0.20,P=0.840]between the remission group and the non-remissio

关 键 词：肝肿瘤 中性粒细胞与淋巴细胞比值 肿瘤坏死因子α 经动脉化疗栓塞术 微波消融 

分 类 号：R735.7[医药卫生—肿瘤]