甲胎蛋白异质体L3和脱γ-羧基凝血酶原在经索拉非尼和经动脉化疗栓塞治疗的晚期原发性肝癌中的预后价值
Prognostic value of AFP-L3 and Des-γ-carboxy prothrombin in advanced primary liver cancer treated with Sorafenib and transarterial chemoembolization.
作者信息
Tang Shiwen, Liu Hao, Chen Peiyang, He Jiaqing, Chen Haiwei, Chen Jingqi, Liu Yanli
机构信息
Department of Clinical Medicine, The Second Clinical College of Guangzhou Medical University Guangzhou, Guangdong, China.
Department of Clinical Medicine, The First Clinical College of Guangzhou Medical University Guangzhou, Guangdong, China.
出版信息
Am J Transl Res. 2024 Sep 15;16(9):5004-5010. doi: 10.62347/PMYP4404. eCollection 2024.
OBJECTIVE
To evaluate the prognostic value of serum alpha-fetoprotein (AFP-L3) and Des-γ-carboxy prothrombin (DCP) in advanced primary liver cancer (PLC) undergoing combined treatment with Sorafenib and transarterial chemoembolization (TACE).
METHODS
This retrospective analysis included 82 patients with advanced PLC treated at the Second Affiliated Hospital, Guangzhou Medical University from January 2018 to January 2020. The patients were divided into an observation group (41 cases) and a control group (41 cases) based on their treatment method. The control group received TACE, while the observation group received a combination of Sorafenib and TACE. Both groups were evaluated after 12 weeks of treatment. Serum AFP-L3 and DCP levels were measured using a chemiluminescence immunoassay with magnetic particles. Short-term efficacy was compared between the two groups after 12 weeks of treatment. Additionally, Karnofsky Performance Status (KPS) scores, serum AFP-L3 and DCP levels before and after 12 weeks of treatment, and the survival rate after 2 years of follow-up were recorded. Serum AFP-L3 and DCP levels were compared between surviving and deceased patients.
RESULTS
The objective response rate in the observation group (68.29%) was higher than in the control group (46.34%) (P<0.05). KPS scores in both groups were significantly higher 12 weeks post-treatment compared to pre-treatment (P<0.05); the observation group had higher post-treatment KPS scores than the control group (P<0.05). Serum AFP-L3 and DCP levels were reduced in both groups after 12 weeks of treatment compared to pre-treatment levels (P<0.05). However, post-treatment serum AFP-L3 and DCP levels were lower in the observation group compared to the control group (both P<0.05). After 2 years of follow-up, the survival rate was higher in the observation group compared to the control group (P<0.05). AFP-L3 and DCP levels were higher in deceased patients compared to surviving patients after 2 years of follow-up (both P<0.05).
CONCLUSION
Combination therapy with Sorafenib and TACE is effective for patients with advanced PLC, reducing AFP-L3 and DCP levels and improving patient survival rates. Additionally, higher levels of serum AFP-L3 and DCP are associated with poor prognosis.
目的
评估血清甲胎蛋白异质体（AFP-L3）和异常凝血酶原（DCP）在接受索拉非尼和经动脉化疗栓塞术（TACE）联合治疗的晚期原发性肝癌（PLC）中的预后价值。
方法
本回顾性分析纳入了2018年1月至2020年1月在广州医科大学附属第二医院接受治疗的82例晚期PLC患者。根据治疗方法将患者分为观察组（41例）和对照组（41例）。对照组接受TACE治疗，而观察组接受索拉非尼和TACE联合治疗。两组在治疗12周后进行评估。采用磁微粒化学发光免疫分析法测定血清AFP-L3和DCP水平。治疗12周后比较两组的短期疗效。此外，记录卡氏功能状态（KPS）评分、治疗12周前后的血清AFP-L3和DCP水平以及随访2年后的生存率。比较存活患者和死亡患者的血清AFP-L3和DCP水平。
结果
观察组的客观缓解率（68.29%）高于对照组（46.34%）（P<0.05）。两组治疗后12周的KPS评分均显著高于治疗前（P<0.05）；观察组治疗后的KPS评分高于对照组（P<0.05）。治疗12周后，两组血清AFP-L3和DCP水平均较治疗前降低（P<0.05）。然而，观察组治疗后的血清AFP-L3和DCP水平低于对照组（均P<0.05）。随访2年后，观察组的生存率高于对照组（P<0.05）。随访2年后，死亡患者的AFP-L3和DCP水平高于存活患者（均P<0.05）。
结论
索拉非尼和TACE联合治疗对晚期PLC患者有效，可降低AFP-L3和DCP水平，提高患者生存率。此外，血清AFP-L3和DCP水平升高与预后不良相关。
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