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影响首次经导管肝动脉化疗栓塞术治疗肝细胞癌患者栓塞后综合征的因素。

Factors influencing postembolization syndrome in patients with hepatocellular carcinoma undergoing first transcatheter arterial chemoembolization.

机构信息

Sun Yat-Sen University Cancer Center, Guangdong, China.

出版信息

J Cancer Res Ther. 2021 Jul;17(3):777-783. doi: 10.4103/jcrt.jcrt_132_21.

Abstract

CONTEXT

Postembolization syndrome (PES) is the most common complication in patients with hepatocellular carcinoma (HCC) who had undergone transcatheter arterial chemoembolization (TACE). PES was defined as fever, nausea and/or vomiting, and abdominal pain and these symptoms develop within 1-3 days after TACE. However, few studies have explored the factors influencing PES in patients with TACE for the first time.

AIMS

We explored the factors influencing PES in patients with HCC undergoing TACE for the first time.

SETTINGS AND DESIGN

The present study was a hospital-based study conducted in the tertiary care hospital of Guangzhou with a retrospective study design.

SUBJECTS AND METHODS

In this single-center retrospective study, a total of 242 patients with HCC were included in the first TACE program between November 1, 2018 and November 31, 2019.

STATISTICAL ANALYSIS USED

T-test and Chi-square test revealed the factors affecting the occurrence of PES. Correlation analysis (Spearman) explored the relationship between these factors and PES. Binary logistics analyzed the predictive factors of PES.

RESULTS

The probability of PES in patients with HCC undergoing TACE for the first time was 55.45%. Types of embolic agents (r = 0.296), types of microspheres (r = 0.510), number of microspheres (r = 0.130), maximum diameter of microspheres used (r = 0.429), type of drug (r = 0.406), and drug loading (r = 0.433) were positively correlated with PES (P < 0.05). Serum albumin was negatively correlated with PES (P = 0.008, r = -0.170). Binary logistic regression analysis revealed that drug loading microspheres (odds ratio [OR] = 0.075, 95% confidence interval [CI] = 0.031-0.180) and serum albumin (OR = 0.182, 95% CI = 0.068-0.487) were the protective factors influencing PES, while drug loading was the risk factor of PES (OR = 1.407, 95% CI = 1.144-1.173).

CONCLUSIONS

Drug loading microspheres, serum albumin, and drug loading were the predictors of PES after the first TACE.

摘要

背景

经导管动脉化疗栓塞术(TACE)后,肝细胞癌(HCC)患者最常见的并发症是栓塞后综合征(PES)。PES 定义为发热、恶心和/或呕吐以及腹痛,这些症状在 TACE 后 1-3 天内出现。然而,很少有研究探讨首次接受 TACE 治疗的 HCC 患者发生 PES 的影响因素。

目的

我们探讨了首次接受 TACE 治疗的 HCC 患者发生 PES 的影响因素。

设置和设计

本研究是一项基于医院的研究,在广州的一家三级保健医院进行,采用回顾性研究设计。

受试者和方法

在这项单中心回顾性研究中,共有 242 例 HCC 患者在 2018 年 11 月 1 日至 2019 年 11 月 31 日期间首次接受 TACE 治疗方案。

使用的统计分析

T 检验和卡方检验揭示了影响 PES 发生的因素。相关性分析(Spearman)探讨了这些因素与 PES 之间的关系。二元逻辑分析了 PES 的预测因素。

结果

首次接受 TACE 治疗的 HCC 患者发生 PES 的概率为 55.45%。栓塞剂类型(r = 0.296)、微球类型(r = 0.510)、微球数量(r = 0.130)、使用的微球最大直径(r = 0.429)、药物类型(r = 0.406)和药物载量(r = 0.433)与 PES 呈正相关(P <0.05)。血清白蛋白与 PES 呈负相关(P = 0.008,r = -0.170)。二元逻辑回归分析显示,药物载量微球(比值比 [OR] = 0.075,95%置信区间 [CI] = 0.031-0.180)和血清白蛋白(OR = 0.182,95% CI = 0.068-0.487)是影响 PES 的保护因素,而药物载量是 PES 的危险因素(OR = 1.407,95% CI = 1.144-1.173)。

结论

药物载量微球、血清白蛋白和药物载量是首次 TACE 后 PES 的预测因子。

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