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目的探讨肝癌患者经导管行肝动脉灌注化疗性栓塞(TACE)治疗前后D-二聚体(Ddimer)变化与疗效及预后的关系。方法选择2011年1月至2011年12月间收治的150例新确诊的原发性肝癌患者,均进行TACE治疗,根据实体瘤疗效评价方法分为疾病进展组(70例)和有效组(80例)。分析治疗前后两组患者的D-dimer指标变化情况以及肿瘤标志物含量。结果 TACE治疗前和治疗后,肝癌患者的血清D-dimer、高尔基体蛋白73(GP73)、甲胎蛋白(AFP)、胸苷激酶1(TK1)、分泌性糖蛋白(DDK1)、血管内皮生长因子(VEGF)、缺氧诱导因子1α(HIF-1α)含量分别为(202.72±27.34)μg/L和(57.94±6.14)μg/L,(498.65±52.14)ng/L和(59.21±6.24)ng/ml,(5.69±0.6)pmol/L和(1.54±0.22)pmol/L,(4.15±0.66)μg/L和(1.38±0.23)μg/L,(247.84±32.15)ng/L和(74.25±9.24)ng/L,(321.29±42.41)ng/L和(125.6±15.22)ng/L(P<0.01);有效组患者的血清D-dimer、GP73、AFP、TK1、DDK1、VEGF、HIF-1α含量分别为(3.76±0.52)μg/L和(4.12±1.02)mg/L,(31.49±6.05)μg/L和(95.24±11.28)μg/L,(56.32±6.12)ng/L和(236.21±21.03)ng/ml,(0.82±0.10)pmol/L和(3.13±0.51)pmol/L,(45.62±6.87)ng/L和(161.62±18.42)ng/L,(52.58±7.20)ng/L和(193.62±25.67)ng/L(均P<0.05)。D-dimer含量与GP73、AFP、TK1、DDK1、VEGF、HIF-1α含量呈正相关(P<0.05)。结论 TACE治疗后D-dimer的含量低于治疗前,复发患者的D-dimer含量高于未复发者,且D-dimer与血清肿瘤标志物具有良好的相关性,是判断肝癌疗效和预后的理想指标。
Objective To investigate the relationship between the change of D-dimer and the curative effect and prognosis of patients with hepatocellular carcinoma before and after transcatheter arterial chemoembolization (TACE). Methods A total of 150 newly diagnosed primary hepatocellular carcinoma (HCC) patients who were admitted between January 2011 and December 2011 were enrolled in this study. All patients underwent TACE treatment. According to the evaluation of the curative effect of solid tumors, they were divided into disease progression group (70 cases) and effective group example). The changes of D-dimer index and the content of tumor markers in both groups before and after treatment were analyzed. Results The levels of serum D-dimer, GP73, AFP, TK1, DDK1 and Vascular Endothelial Growth The levels of VEGF and HIF-1α were (202.72 ± 27.34) μg / L and (57.94 ± 6.14) μg / L, (498.65 ± 52.14) ng / L and (59.21 ± 6.24) (4.15 ± 0.66) μg / L and (1.38 ± 0.23) μg / L, (247.84 ± 32.15) ng / L and (5.69 ± 0.6) pmol / L and (P <0.01). The serum levels of D-dimer, GP73, AFP, TK1, DDK1, VEGF, (3.76 ± 0.52) μg / L and (4.12 ± 1.02) mg / L, (31.49 ± 6.05) μg / L and (95.24 ± 11.28) μg / L and (56.32 ± 6.12) ng / L And (236.21 ± 21.03) ng / ml, (0.82 ± 0.10) pmol / L, and (3.13 ± 0.51) pmol / L, (45.62 ± 6.87) ng / L and (161.62 ± 18.42) ng / L and (52.58 ± 7.20 ) ng / L and (193.62 ± 25.67) ng / L (all P <0.05). The content of D-dimer was positively correlated with the contents of GP73, AFP, TK1, DDK1, VEGF and HIF-1α (P <0.05). Conclusion The D-dimer content of TACE is lower than that before treatment, and the content of D-dimer in relapsed patients is higher than that of non-relapsed patients. And D-dimer has good correlation with serum tumor markers, which is the ideal for judging the efficacy and prognosis of hepatocellular carcinoma index.