發(fā)布時間：2018-05-05 09:12

  本文選題：原發(fā)性肝癌 + 甲胎蛋白　； 參考：《廣西醫(yī)科大學》2017年碩士論文

【摘要】：目的:探討原發(fā)性肝癌患者肝動脈灌注化療栓塞術(shù)前后甲胎蛋白的變化情況與預后的關(guān)系。方法:回顧性分析我院117例經(jīng)TACE術(shù)治療的原發(fā)性肝癌患者的臨床資料,按肝癌患者TACE術(shù)前后甲胎蛋白濃度變化情況將其分為三組:甲組(42例)TACE術(shù)后甲胎蛋白值降低(甲胎蛋白值降低超過20%);乙組(40例)TACE術(shù)后甲胎蛋白值變化不大(甲胎蛋白值降低或上升不超過20%);丙組(35例)TACE術(shù)后甲胎蛋白值上升(甲胎蛋白值上升超過20%)。比較三組患者疾病控制率、生存曲線差異及2年生存率。結(jié)果:甲組DCR=95.24%、乙組DCR=77.50%、丙組DCR=48.57%。三組患者疾病控制率對比差異具有統(tǒng)計學意義(χ~2=22.472 P0.001)。疾病控制率:甲組乙組丙組。甲組與乙組疾病控制率差異具有統(tǒng)計學意義(P=0.018);甲組與丙組疾病控制率差異具有統(tǒng)計學意義(P0.001);乙組與丙組疾病控制率差異具有統(tǒng)計學意義(P=0.009)。甲組患者中位生存時間為21個月,3、6、12、24個月生存率分別為95.2%、84.7%、71.4%、35.7%;乙組患者中位生存時間為15個月,3、6、12、24個月生存率分別為90.0%、80.0%、57.5%、10.0%;丙組患者中位生存時間為12個月,3、6、12、24個月生存率分別為88.6%、74.3%、40.0%、5.71%。log-rank檢驗比較組間差異:甲組與乙組差異具有統(tǒng)計學意義(P=0.008)。甲組與丙組差異具有統(tǒng)計學意義(P0.001)。乙組與丙組差異具無統(tǒng)計學意義(P=0.085)。2年生存率:甲組乙組丙組。甲組患者與乙組患者2年生存率之間差異具有統(tǒng)計學意義(χ~2=7.610,P=0.006)。甲組患者與丙組患者2年生存率之間差異具有統(tǒng)計學意義(χ~2=9.987,P=0.002)。乙組患者與丙組患者2年生存率之間差異無統(tǒng)計學意義(χ~2=0.668,P=0.679)。結(jié)論:1.TACE是治療中晚期肝癌患者的一種有效的方法;2.原發(fā)性肝癌患者TACE術(shù)前、后甲胎蛋白的變化情況可推測其預后情況;3.TACE術(shù)后AFP下降提示預后較好;4.TACE術(shù)后AFP無明顯變化提示療效不佳;5.TACE術(shù)后AFP升高提示預后差。
[Abstract]:Objective: to investigate the relationship between the changes of alpha-fetoprotein and prognosis before and after hepatic artery infusion chemoembolization in patients with primary liver cancer. Methods: the clinical data of 117 patients with primary liver cancer treated by TACE were analyzed retrospectively. According to the changes of alpha-fetoprotein concentration in patients with liver cancer before and after TACE, they were divided into three groups: group A (42 cases) with reduced alpha-fetoprotein (AFP) more than 20% after TACE, and group B (40 cases) had little change in alpha-fetoprotein (Afetoprotein) after TACE. In group C, the alpha-fetoprotein value increased after TACE in 35 cases (the alpha-fetoprotein value increased more than 20%). The disease control rate, survival curve difference and 2-year survival rate were compared among the three groups. Results: the DCRs of group A were 95.24, that of group B was 77.50, and that of group C were 48.57. The difference of disease control rate among the three groups was statistically significant (蠂 2 + 22.472 P 0.001). Disease control rate: group A, group B, group C. The difference of disease control rate between group A and group B was statistically significant, that between group A and group C was statistically significant (P 0.001), and that between group B and group C was statistically significant (P 0.009). The median survival time of group A was 21 months and the survival rate of 24 months was 95.2 and 71.4 respectively. The median survival time of patients in group B was 15 months, and the survival rate of 24 months was 90.080.057.510.0 in group C, the median survival time of group C was 12 months, and the survival rate of 24 months was 24 months, respectively. There were significant differences between the two groups by the log-rank test: the difference between group A and group B was statistically significant (P < 0.05). The difference between group A and group C was statistically significant (P 0.001). There was no significant difference between group B and group C. the 2-year survival rate of group B was 0. 085. The 2-year survival rate of group A and group B was significantly different (蠂 ~ (2) 7.610 ~ (10) P ~ (0.006)). The 2-year survival rate between group A and group C was statistically significant (蠂 2 9.987 P < 0.002). There was no significant difference in 2-year survival rate between group B and group C (蠂 2 0.668 P 0. 679). Conclusion 1. TACE is an effective method for the treatment of advanced liver cancer. The changes of alpha-fetoprotein in patients with primary liver cancer before and after TACE may be predicted. 3. The decrease of AFP after TACE indicates a better prognosis. 4. No significant changes in AFP after TACE suggest poor curative effect. 5. The increase of AFP after TACE indicates poor prognosis.
【學位授予單位】：廣西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R735.7

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