Granito Alessandro, Facciorusso Antonio, Sacco Rodolfo, Bartalena Laura, Mosconi Cristina, Cea Ugo Vittorio, Cappelli Alberta, Antonino Matteo, Modestino Francesco, Brandi Nicolò, Tovoli Francesco, Piscaglia Fabio, Golfieri Rita, Renzulli Matteo
Division of Internal Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40137 Bologna, Italy.
Gastroenterology and Digestive Endoscopy, Department of Medical and Surgical Sciences, University of Foggia, 71100 Foggia, Italy.
J Pers Med. 2021 Oct 17;11(10):1041. doi: 10.3390/jpm11101041.
The aim of the present study was to correlate laboratory data and postprocedural parameters after conventional transarterial chemoembolization (cTACE) for hepatocellular carcinoma (HCC) with the radiological response. The study consisted of a retrospective analysis of prospectively collected data from 70 consecutive patients who underwent cTACE. Laboratory parameters were assessed daily after cTACE and compared to pretreatment values. Post-treatment radiological response was assessed using mRECIST at one month from cTACE, and factors associated with treatment response (complete and objective response) were assessed by logistic regression analysis. The optimal cutoff points in predicting the complete response of target lesions were a 52% ALT and a 46% AST increase after cTACE compared to the pre-treatment values. Using multivariate analyses, >46% AST and >52% ALT increases with respect to the pre-treatment value were significantly correlated with the objective response ( = 0.03 and = 0.04, respectively) and the complete response ( = 0.02 and = 0.02, respectively). No patients experienced liver function deterioration after cTACE, and no specific treatment was required. This study showed that post-treatment transient transaminase elevation was predictive of objective response to superselective cTACE in clinical practice, representing a simple tool to guide treatment strategy of HCC patients in a tailored approach.
本研究的目的是将肝细胞癌（HCC）患者接受传统经动脉化疗栓塞术（cTACE）后的实验室数据和术后参数与放射学反应相关联。该研究包括对70例连续接受cTACE治疗患者的前瞻性收集数据进行回顾性分析。cTACE术后每天评估实验室参数，并与治疗前值进行比较。在cTACE术后1个月使用改良RECIST评估治疗后的放射学反应，并通过逻辑回归分析评估与治疗反应（完全缓解和客观缓解）相关的因素。预测靶病灶完全缓解的最佳截断点是cTACE术后与治疗前值相比，ALT升高52%，AST升高46%。通过多变量分析，与治疗前值相比，AST升高>46%和ALT升高>52%与客观缓解（分别为P = 0.03和P = 0.04）和完全缓解（分别为P = 0.02和P = 0.02）显著相关。cTACE术后无患者出现肝功能恶化，无需特殊治疗。本研究表明，治疗后短暂的转氨酶升高可预测临床实践中对超选择性cTACE的客观反应，是一种以个体化方式指导HCC患者治疗策略的简单工具。
