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评估循环肿瘤细胞对晚期肝细胞癌患者经动脉化疗栓塞治疗预后的预测能力。

Evaluating the predictive power of circulating tumor cells for the prognosis of transarterial chemoembolization treatment on patients with advanced hepatocellular carcinoma.

机构信息

Nanjing Medical University, Nanjing.

Department of Interventional Radiology.

出版信息

Medicine (Baltimore). 2021 Jan 8;100(1):e24060. doi: 10.1097/MD.0000000000024060.

Abstract

Explore the predictive power of Circulating Tumor Cells (CTCs) for evaluating the prognosis of transarterial chemoembolization (TACE) treatment on advanced hepatocellular carcinoma (HCC) patients, and use it to construct a prediction model.We retrospectively analyzed 43 patients with Barcelona Clinic Liver Cancer stage C HCC who underwent TACE treatment.The survival time of 43 advanced HCC patients were 2 to 60 months, with the median survival time of 12 months, 1-, 3-, and 5-year survival rates were 42.9%, 9.0%, and 3.6%, respectively. The OS of patients with high level of CTCs before TACE (CTC1 > 2) was significantly lower than that of patients with low level of CTCs (8 vs 12 months, P = .040), but there was no significant difference in PFS between the 2 groups (P = .926). Meanwhile, there was no significant difference in OS and PFS between patients with high level CTCs and those with low level CTCs at 1 week and 4 weeks after TACE (P all > .05). In univariate and multivariate Cox regression analysis, the number of lesions and CTC before TACE were the independent influencing factors for prognosis in these patients, and the HR was 3.01 and 1.20, respectively (all P < .05). The area under curve of COX regression model to predict OS increased with the increase of follow-up time, ranging from 0.56 to 0.85.The CTCs number before TACE is an effective biomarker for predicting the OS of advanced HCC patients. The joint prediction model based on CTCs and tumor number can effectively predict the prognosis of patients with advanced HCC.

摘要

探讨循环肿瘤细胞(CTC)在评估经动脉化疗栓塞(TACE)治疗晚期肝细胞癌(HCC)患者预后中的预测能力,并构建预测模型。我们回顾性分析了 43 例巴塞罗那临床肝癌(BCLC)分期 C 期 HCC 患者接受 TACE 治疗的情况。43 例晚期 HCC 患者的生存时间为 2-60 个月,中位生存时间为 12 个月,1、3、5 年生存率分别为 42.9%、9.0%和 3.6%。TACE 前 CTC 水平较高(CTC1>2)的患者 OS 明显低于 CTC 水平较低的患者(8 个月 vs 12 个月,P=.040),但两组间 PFS 无显著差异(P=.926)。同时,TACE 后 1 周和 4 周时,高 CTC 组与低 CTC 组的 OS 和 PFS 差异均无统计学意义(P 均>.05)。单因素和多因素 Cox 回归分析显示,TACE 前肿瘤数目和 CTC 是影响此类患者预后的独立影响因素,HR 分别为 3.01 和 1.20(均 P<.05)。COX 回归模型预测 OS 的 AUC 随随访时间的延长而增加,范围为 0.56-0.85。TACE 前 CTC 计数是预测晚期 HCC 患者 OS 的有效生物标志物。基于 CTC 和肿瘤数目的联合预测模型可有效预测晚期 HCC 患者的预后。

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