摘要
目的 研究C反应蛋白/白蛋白比值(CAR)对接受肝动脉栓塞(TAE)联合微波消融(MWA)治疗的中期肝细胞癌(HCC)患者预后的影响。方法?回顾性分析2017年1月至2018年12月行TAE联合MWA治疗的中期HCC患者139例,收集患者临床、实验室及影像学资料,计算患者CAR值,采用受试者工作特征(ROC)曲线确定CAR临界值,将患者分为低CAR组(CAR≤临界值,n=65)及高CAR组(CAR>临界值,n=74),分析CAR与临床指标的相关性;采用Cox回归进行多因素分析,得出影响TAE联合MWA治疗的中期HCC患者预后的独立危险因素。结果 根据ROC曲线,确定CAR临界值为0.26,结果显示低CAR组与高CAR组患者血清胆碱酯酶水平(t=2.254)、肿瘤数目(χ^(2)=9.390)差异均有统计学意义(均P<0.05);Cox多因素分析显示,首次消融状态(HR 4.437,95%CI 2.687~7.327,P<0.001)、CAR(HR 3.913,95%CI2.514~6.092,P<0.001)、肿瘤数目(HR 3.461,95%CI 1.873~6.393,P=0.001)、肿瘤最大径(HR 1.975,95%CI 1.316~2.965,P<0.001)是中期HCC患者TAE联合MWA治疗后生存率的独立影响因素。结论 CAR是影响中期HCC患者TAE联合MWA治疗预后的独立危险因素。
objective To investigate the effect of C-reactive protein/albumin ratio (CAR) on prognosis of intermediate-stage hepatocellular carcinoma (HCC) after treatment of transcatheter arterial embolization (TAE)combined with microwave ablation (MWA).Methods A total of 139 patients diagnosed as intermediate-stage HCC and treated by TAE combined with MWA between Jan.2017 and Dec.2018 were retrospectively analyzed.The baseline clinical,laboratory and imaging data of patients were collected.The baseline CAR was calculated and the cut-off value was determined by receiver operating characteristic (ROC) curve.The patients were divided into low CAR group (CAR≤cut off value,n=65) and high CAR group (CAR>cut off value,n=74).The correlation between CAR and clinical indexes was analyzed.Cox regression was used for multivariate analysis to obtain the independent risk factors affecting the prognosis of intermediate-stage HCC treated with TAE combined with MWA.Results The cut-off value of CAR was determined to be 0.26 according to ROC curve.There were significant differences in cholinesterase (CHE,t=2.254) and tumor number (χ^(2)=9.390) between low CAR group and high CAR group (all P<0.05);Cox multivariate analysis showed that the first ablation status(HR 4.437,95%CI 2.687-7.327,P<0.001),CAR (HR 3.913,95%CI 2.514-6.092,P<0.001),tumor number (HR3.461,95%CI 1.873-6.393,P=0.001) and maximum tumor diameter (HR=1.975,95%CI 1.316-2.965,P<0.001)were independent risk factors for the survival of patients with intermediate-stage HCC.Conclusion CAR is an independent risk factor for intermediate-stage HCC after treatment of TAE combined with MWA.
作者
孙玉
张洪海
袁春旺
龙江
郑加生
张永宏
SUN Yu;ZHANG Honghai;YUAN Chunwang;LONG Jiang;ZHENG Jiasheng;ZHANG Yonghong(Interventional Therapy Center of Liver Disease and Oncology,Beijing You’an Hospital,Capital Medical University,Beijing 100069,China)
出处
《肝胆胰外科杂志》
CAS
2022年第10期587-592,共6页
Journal of Hepatopancreatobiliary Surgery
基金
北京市属医院科研培育计划(PX2022067)。
关键词
肝细胞癌
C反应蛋白
白蛋白
微波消融
预后
危险因素
hepatocellular carcinoma
C-reactive protein
albumin
microwave ablation
prognosis
risk factors
