孙德生 徐宏伟 徐惠亮 陈建尧 杨月明 施涛 沈郁

[摘要] 目的 探討中晚期原发性肝癌患者术前血清甲胎蛋白表达水平与经导管肝动脉化疗栓塞术（TACE）术后疗效和预后的相关性。 方法 回顾性分析2012年1月至2017年4月绍兴第二医院收治的114例TACE治疗的中晚期原发性肝癌患者的临床资料，比较36例AFP阴性患者和78例AFP阳性患者的治疗效果和生存情况。 结果 AFP阴性组第6、12个月的疾病控制率高于AFP阳性组（P<0.05），第36、48个月生存率高于AFP阳性组（P<0.05）。AFP≤400 ng/mL组与AFP>400 ng/mL组患者治疗后疾病控制率和生存率比较，差异均无统计学意义（P>0.05）。 结论 甲胎蛋白水平与中晚期原发性肝癌TACE术后疗效有一定的相关性，TACE对AFP阴性的患者有更好的疗效和预后。

[关键词] 原发性肝癌;甲胎蛋白;肝动脉化疗栓塞术;介入放射学

[中图分类号] R735.7          [文献标识码] B          [文章编号] 1673-9701（2021）35-0001-04

Analysis of correlation between alpha-fetoprotein level and curative effect and prognosis of advanced primary liver cancer after TACE

SUN Desheng1   XU Hongwei1   XU Huiliang2   CHEN Jianyao3   YANG Yueming4   SHI Tao1   SHEN Yu1

1.Department of Radiology，Shaoxing Second Hospital，Shaoxing   312000， China; 2.Department of Tumor Intervention，Shaoxing Second Hospital，Shaoxing   312000， China;3.Department of Hepatopancreatobiliary Surgery，Shaoxing Second Hospital， Shaoxing   312000，China; 4.Department of General Surgery， Shaoxing Second Hospital， Shaoxing   312000，China

[Abstract] Objective To explore the correlation between expression level of serum alpha-fetoprotein before operation and curative effect and prognosis of patients with advanced primary liver cancer after TACE. Methods The clinical data of 114 patients with advanced primary liver cancer treated by TACE from January 2012 to Aprial 2017 in Shaoxing Second Hospital were analyzed retrospectively，and the therapeutic effects and survival conditions of 36 patients with negative AFP and 78 patients with positive AFP were compared. Results The disease control rate of AFP-negative group in the 6th and 12th month was higher than that in the AFP-positive group（P<0.05）， and the survival rate in the 36th and 48th month was higher than that in the AFP-positive group（P<0.05）.There were no significant differences in the disease control rate and survival rate between AFP≤400 ng/mL group and AFP>400 ng/mL group after treatment（P>0.05）. Conclusion The level of alpha-fetoprotein is related to the curative effect of TACE for advanced primary liver cancer， and TACE has better curative effect and prognosis for AFP negative patients.

[Key words] Primary liver cancer; Alpha-fetoprotein; Hepatic arterial chemoembolization; Interventional radiology

原发性肝癌（Primary liver cancer，PLC）是世界上第5大常见恶性肿瘤，死亡率居第3位，我国约占其发病总数和死亡数的50%[1]。经导管肝动脉化疗栓塞术（Transeatheter arterial chemoembolization，TACE）是治疗不能手术的中晚期原发性肝癌首选和最有效的治疗方法[2]，已在临床广泛开展[2-3]。关于AFP阳性肝癌和AFP阴性肝癌接受TACE治疗后临床效果和预后观察目前报道较少。笔者对接受TACE治疗的114例不同AFP表达水平的中晚期原发性肝癌的临床疗效和预后情况进行分析，现报道如下。

1 资料与方法

1.1 一般资料

选取2012年1月至2017年4月我院收治的不能手术的原发性肝癌患者114例，男100例，女14例，年龄38～83岁，平均（62.54±10.81）岁，均经临床、影像或病理学检查确诊，且具有可测量或可评价的肿瘤病灶。……