原发性肝癌TACE术前后甲胎蛋白的变化情况与预后的关系

发布时间：2018-05-05 09:12

本文选题：原发性肝癌 + 甲胎蛋白　；参考：《广西医科大学》2017年硕士论文

【摘要】：目的:探讨原发性肝癌患者肝动脉灌注化疗栓塞术前后甲胎蛋白的变化情况与预后的关系。方法:回顾性分析我院117例经TACE术治疗的原发性肝癌患者的临床资料,按肝癌患者TACE术前后甲胎蛋白浓度变化情况将其分为三组:甲组(42例)TACE术后甲胎蛋白值降低(甲胎蛋白值降低超过20%);乙组(40例)TACE术后甲胎蛋白值变化不大(甲胎蛋白值降低或上升不超过20%);丙组(35例)TACE术后甲胎蛋白值上升(甲胎蛋白值上升超过20%)。比较三组患者疾病控制率、生存曲线差异及2年生存率。结果:甲组DCR=95.24%、乙组DCR=77.50%、丙组DCR=48.57%。三组患者疾病控制率对比差异具有统计学意义(χ~2=22.472 P0.001)。疾病控制率:甲组乙组丙组。甲组与乙组疾病控制率差异具有统计学意义(P=0.018);甲组与丙组疾病控制率差异具有统计学意义(P0.001);乙组与丙组疾病控制率差异具有统计学意义(P=0.009)。甲组患者中位生存时间为21个月,3、6、12、24个月生存率分别为95.2%、84.7%、71.4%、35.7%;乙组患者中位生存时间为15个月,3、6、12、24个月生存率分别为90.0%、80.0%、57.5%、10.0%;丙组患者中位生存时间为12个月,3、6、12、24个月生存率分别为88.6%、74.3%、40.0%、5.71%。log-rank检验比较组间差异:甲组与乙组差异具有统计学意义(P=0.008)。甲组与丙组差异具有统计学意义(P0.001)。乙组与丙组差异具无统计学意义(P=0.085)。2年生存率:甲组乙组丙组。甲组患者与乙组患者2年生存率之间差异具有统计学意义(χ~2=7.610,P=0.006)。甲组患者与丙组患者2年生存率之间差异具有统计学意义(χ~2=9.987,P=0.002)。乙组患者与丙组患者2年生存率之间差异无统计学意义(χ~2=0.668,P=0.679)。结论:1.TACE是治疗中晚期肝癌患者的一种有效的方法;2.原发性肝癌患者TACE术前、后甲胎蛋白的变化情况可推测其预后情况;3.TACE术后AFP下降提示预后较好;4.TACE术后AFP无明显变化提示疗效不佳;5.TACE术后AFP升高提示预后差。
[Abstract]:Objective: to investigate the relationship between the changes of alpha-fetoprotein and prognosis before and after hepatic artery infusion chemoembolization in patients with primary liver cancer. Methods: the clinical data of 117 patients with primary liver cancer treated by TACE were analyzed retrospectively. According to the changes of alpha-fetoprotein concentration in patients with liver cancer before and after TACE, they were divided into three groups: group A (42 cases) with reduced alpha-fetoprotein (AFP) more than 20% after TACE, and group B (40 cases) had little change in alpha-fetoprotein (Afetoprotein) after TACE. In group C, the alpha-fetoprotein value increased after TACE in 35 cases (the alpha-fetoprotein value increased more than 20%). The disease control rate, survival curve difference and 2-year survival rate were compared among the three groups. Results: the DCRs of group A were 95.24, that of group B was 77.50, and that of group C were 48.57. The difference of disease control rate among the three groups was statistically significant (蠂 2 + 22.472 P 0.001). Disease control rate: group A, group B, group C. The difference of disease control rate between group A and group B was statistically significant, that between group A and group C was statistically significant (P 0.001), and that between group B and group C was statistically significant (P 0.009). The median survival time of group A was 21 months and the survival rate of 24 months was 95.2 and 71.4 respectively. The median survival time of patients in group B was 15 months, and the survival rate of 24 months was 90.080.057.510.0 in group C, the median survival time of group C was 12 months, and the survival rate of 24 months was 24 months, respectively. There were significant differences between the two groups by the log-rank test: the difference between group A and group B was statistically significant (P < 0.05). The difference between group A and group C was statistically significant (P 0.001). There was no significant difference between group B and group C. the 2-year survival rate of group B was 0. 085. The 2-year survival rate of group A and group B was significantly different (蠂 ~ (2) 7.610 ~ (10) P ~ (0.006)). The 2-year survival rate between group A and group C was statistically significant (蠂 2 9.987 P < 0.002). There was no significant difference in 2-year survival rate between group B and group C (蠂 2 0.668 P 0. 679). Conclusion 1. TACE is an effective method for the treatment of advanced liver cancer. The changes of alpha-fetoprotein in patients with primary liver cancer before and after TACE may be predicted. 3. The decrease of AFP after TACE indicates a better prognosis. 4. No significant changes in AFP after TACE suggest poor curative effect. 5. The increase of AFP after TACE indicates poor prognosis.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R735.7

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