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目的探讨原发性肝癌患者肝动脉化疗栓塞(TACE)术后预后影响因素及预后诊断指标的价值。方法选取行TACE治疗的84例原发性肝癌患者,采用Cox风险比例模型分析患者的预后因素,另选取80例肝囊肿患者为对照组,采用酶联免疫吸附法测定两组患者的血清AFP、SCC、CYFRA21-1水平。结果经Cox风险比例模型分析可知,门脉癌栓、肝内转移、Child-Pugh分级、AFP术后阳性、SCC术后阳性、CYFRA21-1术后阳性是原发性肝癌患者远期预后的独立危险因素。原发性肝癌组患者TACE术前、术后血清AFP、SCC、CYFRA21-1水平及AFP、SCC、CYFRA21-1阳性率均高于对照组,而TACE术后血清AFP、SCC、CYFRA21-1水平及AFP、SCC、CYFRA21-1阳性率低于TACE术前,差异均有统计学意义(P﹤0.05)。结论 AFP术后阳性、SCC术后阳性、CYFRA21-1术后阳性是原发性肝癌患者TACE术后预后的独立危险因素,在预测原发性肝癌患者TACE术后预后方面具有潜在的临床价值。
Objective To investigate the prognostic factors and the prognostic value of postoperative transcatheter arterial chemoembolization (TACE) in patients with primary liver cancer. Methods Totally 84 patients with primary hepatocellular carcinoma treated with TACE were enrolled in this study. Cox proportional hazards model was used to analyze the prognosis of the patients. Eighty patients with hepatic cysts were selected as the control group. Serum AFP levels were measured by enzyme-linked immunosorbent assay (ELISA) SCC, CYFRA21-1 level. Results Cox proportional hazards model analysis showed that portal vein tumor thrombus, intrahepatic metastasis, Child-Pugh grading, AFP postoperative positive, SCC postoperative positive, CYFRA21-1 positive postoperative prognosis of patients with primary liver cancer is independent Risk factors. The positive rates of serum AFP, SCC, CYFRA21-1, AFP, SCC and CYFRA21-1 in patients with primary liver cancer before TACE were higher than those in control group, while the levels of AFP, SCC, CYFRA21-1 And the positive rates of AFP, SCC and CYFRA21-1 were lower than those before TACE (P <0.05). Conclusions Positive postoperative AFP, positive post SCC, and positive postoperative CYFRA21-1 are independent risk factors for prognosis of primary hepatocellular carcinoma after TACE. It has potential clinical value in predicting the prognosis of patients with primary liver cancer after TACE.