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肝细胞癌经动脉化疗栓塞术后免疫、凝血及生物标志物反应评估的多学科治疗策略

Multidisciplinary treatment strategies for the assessment of immune, coagulation, and biomarker responses after transarterial chemoembolization for hepatocellular carcinoma.

作者信息

Song Tian, Wu Kan-Hua, Yang Hao, Xie Wen-Li, Shen Lan

机构信息

Department of Radiology, Hua Dong Hospital, Fudan University, Shanghai 200040, China.

出版信息

World J Gastrointest Surg. 2025 May 27;17(5):101605. doi: 10.4240/wjgs.v17.i5.101605.

Abstract

BACKGROUND

Currently, there is a notable lack of reliable studies evaluating the impact of multidisciplinary treatment strategies following transarterial chemoembolization (TACE) on patients with hepatocellular carcinoma (HCC), underscoring the urgent need for higher-level research in this area.

AIM

To investigate the association of multidisciplinary treatment strategies with the immunological, coagulation, and tumor biomarker responses after post-TACE in HCC.

METHODS

This retrospective analysis included 100 patients with HCC who were categorized based on the treatment approach into the control (patients treated with TACE alone) and experimental groups (patients receiving multidisciplinary treatment strategies post-TACE). Participant characteristics, short-term efficacy, and safety assessment as well as immunological, coagulation, and tumor biomarker responses between the two groups were collected and compared.

RESULTS

Compared with the control group, the experimental group demonstrated a superior overall response rate, along with an increased fibrinogen, markedly improved immunological biomarker, lower prothrombin time, thrombin time, alpha-fetoprotein, carcinoembryonic antigen, and carbohydrate antigen 199 levels, as well as a decreased abnormal prothrombin incidence, and a lower overall rate of adverse reactions. Notably, no significant difference in the activated partial thromboplastin time and D-dimer levels was observed between the two groups.

CONCLUSION

Multidisciplinary treatment strategies post-TACE have improved the treatment outcome, the immunological response, and the coagulation function, lowered the tumor biomarker response levels, and reduced the risk of adverse reactions in patients with HCC.

摘要

背景

目前,缺乏可靠的研究评估经动脉化疗栓塞术(TACE)后多学科治疗策略对肝细胞癌(HCC)患者的影响,这凸显了该领域开展更高水平研究的迫切需求。

目的

探讨多学科治疗策略与HCC患者TACE术后免疫、凝血及肿瘤生物标志物反应之间的关联。

方法

本回顾性分析纳入100例HCC患者,根据治疗方法分为对照组(仅接受TACE治疗的患者)和试验组(TACE术后接受多学科治疗策略的患者)。收集并比较两组患者的特征、短期疗效、安全性评估以及免疫、凝血和肿瘤生物标志物反应。

结果

与对照组相比,试验组的总体反应率更高,纤维蛋白原增加,免疫生物标志物明显改善,凝血酶原时间、凝血酶时间、甲胎蛋白、癌胚抗原和糖类抗原199水平降低,异常凝血酶原发生率降低,不良反应总发生率降低。值得注意的是,两组之间活化部分凝血活酶时间和D-二聚体水平无显著差异。

结论

TACE术后多学科治疗策略改善了HCC患者的治疗效果、免疫反应和凝血功能,降低了肿瘤生物标志物反应水平,降低了不良反应风险。

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