术前血清γ-谷氨酰转肽酶水平对老年肝细胞癌患者行肝动脉化疗栓塞术后预后的影响分析

Analysis of effect of preoperative serum γ-glutamyltranspeptides level on prognosis of elderly patients with hepatocellular carci-noma after hepatic arterial chemoembolization

中文关键词: 老年  肝细胞癌  肝动脉化疗栓塞术  血清γ-谷氨酰转移酶  生存时间  预后

英文关键词: elderly  hepatocellular carcinoma  transcatheter artery chemoembolization  serum γ-glutamyltransferase  survival time  prognosis

中文摘要:

      目的 探究术前血清γ-谷氨酰转肽酶(GGT)水平对老年肝细胞癌(HCC)患者行肝动脉化疗栓塞术(TACE)术后预后的影响因素.方法 回顾性分析2016 年1 月—2019 年12 月在成都市公共卫生临床医疗中心接受治疗的 272 例老年HCC患者的临床资料,将其中进行TACE的89 例患者作为观察组,未进行TACE的 183 例患者作为对照组.根据既往的研究,选择可能与生存有关的临床病理因素,进行单因素和多因素Cox分析,以识别总体生存的独立预测因素.结果 单变量分析结果显示,总胆红素＞20.4 mmol/L(HR =1.52,P =0.015)、GGT＞54 U/L(HR =2.02,P＜0.001)、区域淋巴结转移(HR =1.58,P =0.014)和ES级Ⅲ～Ⅳ(HR =1.50,P =0.007)是与HCC老年患者术后生存时间相关的可能因素.在血清GGT水平≤54 U/L的患者中,ES分级Ⅲ～Ⅳ(HR≤1.94,P≤0.030)是生存的唯一重要危险因素.观察组和对照组患者术后生存时间差异无统计学意义(中位生存时间分别为38 个月和26 个月,P =0.818).TACE不是与生存相关的独立变量(HR =0.89,P =0.704).在血清GGT水平＞54 U/L的患者中,TACE(HR =0.44,P = 0.001)和ES级Ⅲ～Ⅳ(HR =1.65,P =0.016)是生存的独立预后因素.观察组患者生存时间长于对照组.结论 术前血清GGT水平较高的老年HCC患者行TACE后,其生存时间可能显著延长.

英文摘要:

      Objective To explore the influence factors of preoperative serum γ?glutamyltranspeptidyase (GGT) level on prognosis of elderly patients with hepatocellular carcinoma (HCC) after hepatic arterial chemoembolization (TACE). Methods The clinical data of 272 elderly HCC patients treated in Public Health Clinical Medical Center of Chengdu City from January 2016 to December 2019 were retrospectively analyzed. Among them, 89 patients who underwent TACE were included in the observation group, and 183 ones who did not undergo TACE were included in the control group. Based on previous stud? ies, clinicopathological factors that may be related to survival were selected, and univariate and multifactorial Cox analyses were performed to identify independent predictors of overall survival. Results Univariate analysis showed that total bilirubin > 20. 4 mmol / L (HR =1. 52, P =0. 015), GGT >54 U / L (HR =2. 02, P <0. 001), regional lymph node metastasis (HR = 1?? 58, P =0. 014) and ES grade III?IV (HR =1. 50, P =0. 007) were possible factor related to postoperative survival time in elderly patients with HCC. In patients with serum GGT levels≤54 U / L, ES grade III?IV (HR≤1. 94, P≤0. 030) was the on? ly significant risk factor for survival. There was no significant difference in postoperative survival time between the observation group and the control group (median survival time was 38 months and 26 months, respectively, P =0. 818). TACE was not an independent variable related to survival (HR =0. 89, P =0. 704). In patients with serum GGT levels >54 U / L, TACE (HR = 0. 44, P =0. 001) and ES grade III?IV (HR =1. 65, P =0. 016) were independent prognostic factors for survival. The survival time of the observation group was longer than that of the control group. Conclusion The survival time of elderly HCC patients with high serum GGT level before surgery may be significantly prolonged after TACE.