Liu Shuai-Wei, Zhou Yan, Feng Xue Yan, Hai Long, Ma Wan-Long, Ma Li Na, Ding Xiang-Chun, Luo Xia
Department of Infectious Diseases, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, 750004, People's Republic of China.
Infectious Disease Clinical Research Center of Ningxia, Yinchuan, Ningxia, 750004, People's Republic of China.
J Hepatocell Carcinoma. 2025 Jun 5;12:1141-1154. doi: 10.2147/JHC.S519397. eCollection 2025.
Drug-eluting bead transcatheter arterial chemoembolization (DEB-TACE) is commonly used to treat unresectable hepatitis B-related primary liver cancer, but its therapeutic effect is influenced by various factors. This study analyzes the clinical factors related to the overall survival (OS) and progression-free survival (PFS) of patients with hepatitis B-related hepatocellular carcinoma (HCC) treated with DEB-TACE to provide reference data for individualized treatment.
In this retrospective study, 128 patients with hepatitis B-related primary liver cancer who received DEB-TACE treatment and being followed up (range of follow-up: 4-39 months) were included. The relationships between clinical characteristics, tumor markers, inflammatory factors, blood biochemical parameters, and OS and PFS were analyzed. Statistical methods, including Kaplan-Meier analysis, the Log rank test, and Cox regression analysis, were used to evaluate independent factors affecting patient prognosis.
Factors such as tumor size, tumor number, vascular invasion, extrahepatic metastasis, stage (CNLC and BCLC), and alpha-fetoprotein (AFP) level significantly affected OS and PFS (P < 0.05). In particular, patients with a tumor diameter >5 cm, multiple tumors, portal vein invasion, and extrahepatic metastasis had significantly shorter OS and PFS. Preoperative inflammatory factors (eg, white blood cell count, absolute neutrophil count, procalcitonin, and C-reactive protein) and blood biochemical parameters (eg, aspartate aminotransferase (AST), total bilirubin (TBIL), albumin (ALB)) were closely related to patient prognosis. Multivariate Cox regression analysis revealed that age, Child-Pugh score, BCLC stage, TBIL, ALB, CRP, and AFP were independent prognostic factors for OS.
This study highlights the significance of tumor clinical characteristics and preoperative inflammatory factors in predicting the prognosis of patients with hepatitis B-related HCC treated with DEB-TACE. By comprehensively evaluating these clinical and biological markers, more personalized treatment plans can be developed for liver cancer patients, thereby improving treatment outcomes and survival rates.
载药微球经导管动脉化疗栓塞术（DEB-TACE）常用于治疗不可切除的乙型肝炎相关原发性肝癌，但其治疗效果受多种因素影响。本研究分析接受DEB-TACE治疗的乙型肝炎相关肝细胞癌（HCC）患者总生存期（OS）和无进展生存期（PFS）的相关临床因素，为个体化治疗提供参考数据。
本回顾性研究纳入128例接受DEB-TACE治疗且正在接受随访（随访时间范围：4 - 39个月）的乙型肝炎相关原发性肝癌患者。分析临床特征、肿瘤标志物、炎症因子、血液生化参数与OS和PFS之间的关系。采用Kaplan-Meier分析、Log rank检验和Cox回归分析等统计方法评估影响患者预后的独立因素。
肿瘤大小、肿瘤数量、血管侵犯、肝外转移、分期（CNLC和BCLC）以及甲胎蛋白（AFP）水平等因素显著影响OS和PFS（P < 0.05）。特别是肿瘤直径>5 cm、多发肿瘤、门静脉侵犯和肝外转移的患者OS和PFS明显缩短。术前炎症因子（如白细胞计数、绝对中性粒细胞计数、降钙素原和C反应蛋白）和血液生化参数（如天冬氨酸转氨酶（AST）、总胆红素（TBIL）、白蛋白（ALB））与患者预后密切相关。多因素Cox回归分析显示，年龄、Child-Pugh评分、BCLC分期、TBIL、ALB、CRP和AFP是OS的独立预后因素。
本研究强调了肿瘤临床特征和术前炎症因子在预测接受DEB-TACE治疗的乙型肝炎相关HCC患者预后中的重要性。通过综合评估这些临床和生物学标志物，可以为肝癌患者制定更个性化的治疗方案，从而改善治疗效果和生存率。
