肝脏 MRI 和临床发现预测肝癌经载药微球动脉化疗栓塞治疗后的反应。

Liver MRI and clinical findings to predict response after drug eluting bead transarterial chemoembolization in hepatocellular carcinoma.

机构信息

Department of Radiology, Chonnam National University Hwasun Hospital, 322 Seoyang-ro, Hwasun, 58128, Korea.

Department of Radiology, Chonnam National University Hospital, 42 Jebong-ro, Dong-gu, Gwangju, 61469, Korea.

出版信息

Sci Rep. 2021 Dec 15;11(1):24076. doi: 10.1038/s41598-021-01839-6.

Abstract

To identify the gadoxetic acid (GA)-enhanced magnetic resonance imaging (MRI) and laboratory findings that enable prediction of treatment response and disease-free survival (DFS) after the first session of drug eluting bead transarterial chemoembolization (DEB-TACE) in patients with hepatocellular carcinoma (HCC). A total of 55 patients who underwent GA-enhanced MRI and DEB-TACE from January 2014 to December 2018 were included. All MRI features were reviewed by two radiologists. Treatment response was evaluated according to the modified Response Evaluation Criteria in Solid Tumors. Univariate and multivariate logistic regression analyses were used to determine predictive factors of treatment response and DFS, respectively. A total of 27 patients (49.1%) achieved complete response (CR) after one session of treatment. There were no significant differences between the two groups in terms of clinical and laboratory characteristics. Heterogeneous signal intensity in the hepatobiliary phase (HBP) was the only independent predictor of non-CR (odds ratio, 4.807; p = 0.048). Recurrent HCC was detected in 19 patients (70.4%) after CR. In the multivariate analysis, elevated serum alpha-fetoprotein (AFP) level (≥ 30 ng/mL) was the only significant parameter associated with DFS (hazard ratio, 2.916; p = 0.040). This preliminary study demonstrated that heterogeneous signal intensity in the HBP and high serum AFP were useful predictive factors for poor treatment response and short DFS after DEB-TACE, respectively.

摘要

目的

确定钆塞酸增强磁共振成像(MRI)和实验室检查结果,以便预测肝细胞癌(HCC)患者首次接受载药微球动脉化疗栓塞(DEB-TACE)治疗后的治疗反应和无病生存(DFS)。

方法

共纳入 2014 年 1 月至 2018 年 12 月期间行 GA 增强 MRI 和 DEB-TACE 的 55 例患者。由 2 位放射科医生对所有 MRI 特征进行评估。根据实体瘤反应评估标准对治疗反应进行评估。采用单因素和多因素逻辑回归分析分别确定治疗反应和 DFS 的预测因素。

结果

共有 27 例(49.1%)患者在一次治疗后达到完全缓解(CR)。两组患者的临床和实验室特征无显著差异。肝胆期(HBP)信号强度不均匀是未达到 CR 的唯一独立预测因素(比值比,4.807;p = 0.048)。19 例(70.4%)CR 患者在随访中发现 HCC 复发。多因素分析显示,血清甲胎蛋白(AFP)水平升高(≥ 30 ng/mL)是与 DFS 相关的唯一显著参数(风险比,2.916;p = 0.040)。

结论

本研究初步表明,HBP 信号强度不均匀和血清 AFP 水平升高分别是 DEB-TACE 治疗反应不良和 DFS 较短的有用预测因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8989/8674226/597d684b602c/41598_2021_1839_Fig1_HTML.jpg

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