异常凝血酶原评价射频消融术治疗原发性肝癌疗效的价值

Applied value of PIVKA-Ⅱin the evaluation of radiofrequency ablation of Primary liver cancer

目的探讨异常凝血酶原(PIVKA-Ⅱ)用于评价射频消融术(RFA)治疗原发性肝癌疗效的价值。方法选择行射频消融术的原发性肝癌患者64例,根据治疗效果分为好转组40例和进展组24例,检测2组术前和术后1个月、6个月血清PIVKA-Ⅱ及甲胎蛋白(AFP)水平,观察2组中射频消融术后AFP阴性(AFP <400 ng/m L)患者血清PIVKA-Ⅱ及AFP水平变化情况,并对PIVKA-Ⅱ与AFP的相关性进行分析。结果好转组术后1个月、6个月PIVKA-Ⅱ、AFP水平均明显低于术前(P均<0. 05),进展组术后1个月、6个月PIVKA-Ⅱ、AFP水平均明显高于术前(P均<0. 05)。AFP阴性的患者中,好转组术后1个月、6个月PIVKA-Ⅱ水平均明显低于术前(P均<0. 05),进展组均明显高于术前(P均<0. 05);好转组和进展组术后1个月、6个月AFP水平与术前比较差异均无统计学意义(P均>0. 05)。PIVKA-Ⅱ与AFP无明显相关性。结论 PIVKA-Ⅱ和AFP均可用于评估原发性肝癌射频消融术后疗效;在AFP <400 ng/m L并行射频消融术的患者中,PIVKA-Ⅱ可辅助AFP评估术后疗效。

Objective It is to evaluate the value of abnormal prothrombin(PIVKA-Ⅱ)in evaluating the efficacy of radiofrequency ablation(RFA)in the treatment of primary liver cancer.Methods Sixty-four patients with primary liver cancer who underwent RFA were enrolled and divided into effiecacy group(n=40)and ineffiecacy group(n=24)according to the treatment effect.The levels of serum PIVKA-Ⅱand alpha-fetoprotein(AFP)were measured before and in 1 month and 6 months after surgery in the two groups,the changes of serum PIVKA-Ⅱand AFP levels in patients with AFP negative(AFP<400 ng/mL)after radiofrequency ablation were observed.The correlation between PIVKA-Ⅱand AFP was analyzed.Results The levels of PIVKA-Ⅱand AFP in the effiecacy group were significantly lower than those in the first month and 6 months after operation(P<0.05).The PIVKA-Ⅱand AFP levels were significantly higher in the ineffiecacy group at 1 and 6 months after operation.Among the AFP-negative patients,the PIVKA-Ⅱlevel at 1 month and 6 months after operation were significantly lower than that before surgery in effiecacy group(P<0.05),and the indexes in the ineffiecacy group were significantly higher than that before surgery(P<0.05).The differences in AFP levels in the 1st and 6th months after operation in the two groups were not significant compared with those before operation(P>0.05).There was no significant correlation between PIVKA-Ⅱand AFP.Conclusion Both PIVKA-Ⅱand AFP can be used to evaluate the efficacy of radiofrequency ablation in primary liver cancer.PIVKA-Ⅱcan assist AFP in evaluating postoperative outcomes in patients with AFP<400 ng/mL parallel radiofrequency ablation.