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异常凝血酶原对肝细胞癌经肝动脉化疗栓塞术后短期疗效的评价价值
Value of abnormal prothrombin in evaluating the short-term efficacy of transcatheter arterial chemoembolization in patients with hepatocellular carcinoma
文章发布日期:2020年08月22日  来源:  作者:查俊豪,郭金和  点击次数:531次  下载次数:25次

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【摘要】:目的 探讨异常凝血酶原(PIVKA-Ⅱ)在肝细胞癌患者经肝动脉化疗栓塞术(TACE)后短期疗效监测中的评价价值。方法 回顾性分析2019年1月-12月东南大学附属中大医院收治的114例肝细胞癌患者临床资料,患者单纯接受传统TACE治疗且PIVKA-Ⅱ基线数值≥40.00 mAU/ml。分析TACE术前与术后第1、3、6个月之间PIVKA-Ⅱ血清学反应情况,并与同期影像学反应(采用mRECIST标准)进行对照分析。采用Spearman相关性分析探索血清学反应与同期影像学反应的相关性。采用配对χ2检验探索血清学反应与影像学反应评价方式敏感度的一致性。以影像学反应为金标准,分析PIVKA-Ⅱ血清学反应的真实性及可靠性评价指标。结果 纳入患者的PIVKA-Ⅱ水平为7225.44(40.13~30 000.00)mAU/ml。术后1、3、6个月,分别有104(91.2%)、94(90.3%)、86(90.5%)例患者分为血清学有反应组,分别有103(90.3%)、90(86.5%)、82(86.3%)例患者分为影像学有反应组。Spearman相关性分析提示,影像学反应与血清学反应呈正相关(术后1、3、6个月对应r值分别为0.739、0.731、0.708,P值均<0.001)。配对χ2检验提示血清学反应与影像学反应评价方式敏感度较为一致(术后1、3、6个月χ2值分别为0、1.5、1.5,P值分别为1.000、0.219、0.219)。血清学反应的真实性和可靠性评价指标均维持在较高的水准。结论 基于影像学反应评价标准,PIVKA-Ⅱ 对肝细胞癌患者TACE短期疗效有良好的评价价值。
【Abstract】:Objective To investigate the value of abnormal prothrombin [protein induced by vitamin K absence or antagonist-Ⅱ(PIVKA-Ⅱ)] in monitoring the short-term efficacy of transcatheter arterial chemoembolization (TACE) in patients with hepatocellular carcinoma (HCC). Methods A retrospective analysis was performed for the clinical data of 114 patients with HCC who were admitted to Zhongda Hospital Affiliated to Southeast University from January to December, 2019, and all patients received conventional TACE alone and had a baseline PIVKA-Ⅱ level of ≥40.00 mAU/ml. Serological response of PIVKA-Ⅱ was observed before TACE and at 1, 3, and 6 months after TACE and was compared with radiological response at the same time point (based on mRECIST guidelines). A Spearman correlation analysis was used to investigate the correlation between serological response and radiological response. The paired chi-square test was used to analyze the consistency between the sensitivity of serological response and that of radiological response. Radiological response was used as the gold standard to investigate the validity and reliability assessment indices of the serological response of PIVKA-Ⅱ. Results The patients enrolled in this study had a PIVKA-Ⅱ level of 7225.44 (40.13-30 000.00) mAU/ml. At 1, 3, and 6 months after TACE, 104 patients (91.2%), 94 patients (90.3%), and 86 patients (90.5%), respectively, had serological response, while 103 patients (90.3%), 90 patients (86.5%), and 82 patients (86.3%) had radiological response. The Spearman correlation analysis showed that radiological response was positively correlated with serological response at 1, 3, and 6 months after TACE (r=0.739, 0.731, and 0.708, all P<0.001). The paired chi-square test showed that serological response and radiological response had a relatively consistent sensitivity in assessment at 1, 3, and 6 months after TACE (χ2=0, 1.5, and 1.5, P=1.000, 0.219, and 0.219). The validity and reliability assessment indices of serological response maintained at a relatively high level. Conclusion Based on the criteria for radiological response, PIVKA-Ⅱ has a good value in monitoring the short-term efficacy of TACE in patients with HCC.
【关键字】:癌,肝细胞; 化学栓塞,治疗性; 异常凝血酶原; 治疗结果
【Key words】:carcinoma,hepatocellular; chemoembolization,therapeutic; PIVKA-Ⅱ; treatment outcome
【引证本文】:ZHA JH, GUO JH. Value of abnormal prothrombin in evaluating the short-term efficacy of transcatheter arterial chemoembolization in patients with hepatocellular carcinoma[J]. J Clin Hepatol, 2020, 36(9): 1990-1993. (in Chinese)
查俊豪, 郭金和. 异常凝血酶原对肝细胞癌经肝动脉化疗栓塞术后短期疗效的评价价值[J]. 临床肝胆病杂志, 2020, 36(9): 1990-1993.

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