血清GGT对肝癌患者经肝动脉化疗栓塞治疗后预后的预测价值  

Predictive Value of Serum GGT for the Prognosis of Hepatocellular Carcinoma after Transcatheter Arterial Chemoembolization

作　　者：陈磊[1] 何昌霞[1] 丁德权[1] 

机构地区：[1]安徽省马鞍山市人民医院,243000

出　　处：《实用癌症杂志》2015年第4期620-622,628,共4页The Practical Journal of Cancer

摘　　要：目的探讨原发性肝癌(HCC)患者经肝动脉化疗栓塞(TACE)治疗后,血清γ-谷氨酰转肽酶(GGT)对判断预后的价值。方法总共有150例中期HCC患者连续用肝动脉栓塞化疗。总生存(OS)用Kaplan-Meier法进行了评估。根据治疗前GGT值,Log-rank对数秩方法评估显著差异。单变量和多变量分析用于预后因素的研究。结果中位随访期为18.7个月。正常GGT的患者1年和3年生存率分别为71.6%和38.5%,高GGT患者1年和3年生存率分别8.8%和16.9%(P=0.002)。高GGT患者的肿瘤偏大,甲胎蛋白(AFP)和丙氨酸转氨酶水平偏高,高GGT是患者OS的独立预后因素之一(P=0.009),其他预后因素包括肿瘤大小和腹腔积液。此外,在小肝癌和正常AFP亚组的血清GGT也与患者OS相关(P=0.013和0.041)。结论 GGT水平是预测肝癌患者肝动脉栓塞化疗治疗预后的一个重要因素。GGT和AFP的联合能更好预测TACE的治疗效果。Objective To investigate the predictive value of serum γ-glutamyl peptidase(GGT) for the prognosis of hepatocellular carcinoma(HCC) after hepatic arterial chemoembolization(TACE).Methods 150 cases of the middle HCC patients received TACE.Overall survival(OS) were evaluated by Kaplan-Meier method.According to pretreatment GGT value,significant differences were evaluated by log rank method.Univariate and multivariate analysis was used in the study of prognostic factors.Results The median follow-up period was 18.7 months.1-and 3-year survival rates of patients with normal GGT were71.6% and 38.5%,and those with high GGT were 8.8% and 16.9%(P = 0.002).Patients with high GGT had large tumors,high alpha-fetoprotein(AFP) and alanine aminotransferase levels,high GGT was an independent prognostic factor of OS(P =0.009),other prognostic factors included tumor size and ascites.In addition,serum GGT in small hepatocellular carcinoma and normal AFP subgroups was associated with OS(P = 0.013 and 0.041).Conclusion GGT level has important predictive value for the prognosis of HCC after TACE.Combined detection of AFP and GGT has better predictive value for efficacy of TACE.

关 键 词：肝癌 预后价值 血清γ-谷氨酰转移酶 肝动脉栓塞化疗栓塞术 

分 类 号：R735.7[医药卫生—肿瘤]