术前γ-谷氨酰转肽酶水平对评估结直肠癌肝转移患者微波消融预后的价值

Prognostic significance of perioperative serum gamma-glutamyl transferase level evaluating microwave ablation of patients with colorectal liver metastases

目的本研究旨在探讨术前γ-谷氨酰转肽酶(gamma-glutamyl transferase,GGT)水平对评估结直肠癌肝转移患者行肝转移瘤微波消融(microwave ablation,MWA)治疗后预后的价值。方法回顾性搜集80例接受肝转移瘤MWA治疗的结直肠癌肝转移患者,按照MWA术前GGT水平分为两组:高GGT组45例(GGT≥60U/L),正常GGT组35例(GGT<60U/L),比较两组的生存状况及预后因素。结果高GGT组和正常GGT组患者12、18、24个月的生存率分别为62.22%、46.67%、26.67%和82.86%、71.43%、48.57%,中位生存时间分别为15.3个月和23.5个月(P<0.05)。Cox多元回归分析显示:术前GGT水平、肝转移灶大小是结直肠癌肝转移患者生存的独立危险因素,Child-Pugh分级是结直肠癌肝转移患者生存的独立保护因素。结论术前GGT水平可以作为评估MWA治疗结直肠癌肝转移患者生存的独立预后因素。

Objective To explore prognostic significance of perioperative serum gamma-glutamyl transferase(GGT)level evaluating patients with colorectal liver metastases treated with microwave ablation(MWA).Methods A retrospective analysis was conducted on 80 patients with colorectal liver metastases who received MWA treatment.Survival rates and prognostic significance were compared between 45 patients(high GGT group,GGT≥60 U/L)and 35 patients(normal GGT group,GGT<60 U/L).The survival rates were calculated by using the Kaplan-Meier method.The Log-rank method was used for univariate analysis,and the Cox regression model was used for multivariate analysis.Results After patients were treated with WMA,the 1,2,3 year survival rates were 62.22%,46.67%,and 26.67%,and the median survival time was 15.3 months in the normal GGT group.The 1,2,3 year survival rates were 82.86%,71.43%,and 48.57%,respectively,and the median survival time was 23.5 months in the high GGT group on the median survival time(P<0.05).The COX multivariate survival analysis revealed that the level of perioperative serum GGT and metastases size were independent risk factors for patients with colorectal liver metastases,Child-Pugh classification was independent protective factor for patients with colorectal liver metastases.Conclusion The level of perioperative serum GGT was an important prognostic factor to evaluate the effect of MWA on patients with colorectal liver metastases.