血清前白蛋白在多结节型肝癌介入治疗中的临床意义

Clinical significance of serum prealbumin in treatment of multinodullar hepatocellular carcinoma with chemoembolization

目的:探讨术前血清前白蛋白(PAB)水平在碘油化疗栓塞多结节型肝癌中的临床意义。方法:将接受碘油(≤10ml)化疗栓塞治疗经动脉灌注化疗栓塞术(TACE)的多结节型肝癌患者术后1周内出现肝功能失代偿的病例定为A组(9例),无明显肝功失代偿为B组(27例),回顾分析36例肝癌患者治疗前PAB水平及临床肝功能分级情况与治疗后PAB水平、肝功能失代偿的关系。结果:A、B两组术前PAB值分别为(81.00±25.89)mg/L和(146.18±49.64)mg/L,术后PAB值分别为(53.33±24.96)mg/L和(119.59±43.13)mg/L,组间比较差异有极显著性(P<0.01);A,B组治疗前后PAB水平组内比较差异有极显著性(P<0.01,P<0.05)。结论:PAB是评价肝功能和预测治疗后肝功能失代偿的可靠指标。术前PAB水平显著降低的患者常规法碘油化疗栓塞后容易发生肝功能失代偿。

Objective：To evaluate the clinical significance of preoperative serum prealbumin （PAB） in the treatment of multidonular hepatocellular carcinoma （HCC） with iodinated oil transcatheter hepatic arterial chemoembolization （TACE）.Methods：The patients with muhinodular HCC undergoing TACE by iodinated oil （≤ 10 mL） were divided into the group A （9 cases） with liver function discompensation in postoperative 1 week and the group B（27 cases） without obvious liver function discompensation.The relation between the preopera- tive PAB levels and liver function Child-Pugh classification status with postoperative PAB levels and liver function discompensation was retrospectively analyzed in 36 patients with HCC.Results：The preoperative PAB levels in the group A and B were （81± 25.89） mg/L and （146.18± 49.64）mg/L respectively, while the postoperative PAB levels were （53.33± 24.96）mg/L and （119.59± 43.13）mg/L respectively, there was obviously statistical difference between the two groups（P〈0.01）.The preoperative and postoperative PAB levels had also statistical difference in the group A and B（P〈0.01 ,P〈0.05）.Conclusion ：Serum PAB is a reliable index for evaluating liver function and predicting postoperative liver function discompensation. The patients with obviously decreased preoperative PAB level are susceptible to develop the liver function discompensation after conventional iodinated oil chemoembolization.