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血清白细胞介素-6和γ-谷氨酰转移酶联合检测对TACE治疗AFP阴性肝癌患者的疗效与预后评价
作者:王京艳 王华明 刘妍 杨锐创 周霖 杨慧银 刘春梓 徐东平 
单位:100853  北京 解放军医学院(王京艳、徐东平) 100039  北京 解放军总医院第五医学中心临床研究管理中心(刘妍、杨锐创、徐东平) 介入科(王京艳、王华明、周霖、杨慧银、刘春梓) 
关键词:甲胎蛋白 白细胞介素-6 γ-谷氨酰转移酶 肝细胞癌 
分类号:R735.7
出版年,卷(期):页码:2019,44(5):394-399
摘要:

 [摘要]  目的  分析多个血清标志物联合检测对甲胎蛋白(AFP)阴性原发性肝癌患者经导管肝动脉化疗栓塞术(TACE)治疗后疗效及预后的临床价值。方法  纳入解放军总医院第五医学中心20169月至20183月接受TACE治疗的120例肝细胞癌(HCC)患者,其中44AFP水平正常(AFP阴性)76AFP水平增高(AFP阳性),分别检测患者TACE 术前、术后1个月和3个月的血清AFP、癌胚抗原(CEA)、糖类抗原-199(CA199)CA125γ-谷氨酰转移酶(GGT)、白细胞介素-2(IL-2)IL-4IL-6IL-10IFN-γTNF-α等指标水平。随访至20187月,观察患者肿瘤活性情况,分析不同标志物组合对AFP阴性HCC患者TACE术后疗效及预后的临床价值。结果  AFP阴性和阳性患者术前各项指标水平比较,差异均无统计学意义(P>0.05)IL-6联合GGT检测AFP阴性和阳性HCC患者TACE术后疗效及预后的灵敏度、特异度、阴性预测值、阳性预测值分别为95.2%87.0%87.0%95.2%85.7%59.6%70.1%79.1%IL-6AFP阴性及阳性HCC患者预后的ROC曲线下面积分别为0.8390.666结论  血清IL-6联合GGT检测可作为一种预测AFP阴性HCC 患者TACE术后疗效及肿瘤活性的有效指标。

 [Abstract]  Objective  To analyze the clinical value of combined detection of several serum markers in the treatment and prognosis of patients with alpha-fetoprotein (AFP)-negative hepatocellular carcinoma (HCC) after transcatheter arterial chemoembolization (TACE). Methods  A total of 120 patients (from September 2016 to March 2018) diagnosed with HCC followed by TACE are recruited in this study. Serum samples were collected and dynamic markers, serum AFP, carcinoembryonic antigen (CEA), carbohydrate antigen-199 (CA199), CA125, gamma-glutamyltranspeptidase (GGT), interleukin (IL)-2, IL-4, IL-6, IL-10, γ-interferon (IFN-γ), and tumor necrosis factor α (TNF-α) levels were detected in 44 AFP-negative patients and 76 AFP-positive patients prior, 1 and 3 months after TACE. During the follow-up period, the tumor activity of patients was monitored and the clinical value of different marker combinations on the efficacy and prognosis of AFP-negative HCC patients after TACE was analyzed until July 2018. Results  There was no statistically significant difference in the pre-operative indicator levels between AFP-negative and AFP-positive patients (P>0.05). The sensitivity, specificity, negative predictive value, and positive predictive value of IL-6 combined with GGT in detecting the efficacy and prognosis of AFP-negative and AFP-positive patients were 95.2%, 87.0%, 87.0%, 95.2% and 85.7%, 59.6%, 70.1%, and 79.1%, respectively. The area under the ROC curve of IL-6 for the prognosis of AFP-negative and AFP-positive HCC patients was 0.839 and 0.666. Conclusion  Serum IL-6 combined with GGT can be used as an effective indicator for predicting the efficacy and tumor activity of AFP-negative HCC patients after TACE.

基金项目:
北京市自然科学基金面上项目(7172206),全军医学科技青年培育项目(15QNP085)
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