乙肝相关性肝癌患者术前血清酶变化及对TACE术预后意义

Preoperative Changes of Serum Enzymes in Patients with HBV-related hepatocellular Carcinoma and their prognostic Significance after TACE

目的对乙肝相关性肝癌患者术前血清酶水平变化及TACE术预后意义进行探讨。方法收集深圳市宝安区人民医院2013年12月-2018年12月接受TACE治疗的80例肝癌合并乙肝感染患者术前血清样本80例,同期肝血管瘤患者32例,健康对照组32例,用秩和检验比较各组碱性磷酸酶、γ-谷胺酰转移酶、α-L-岩藻糖苷酶、胆碱酯酶、谷丙转氨酶、谷草转氨酶、乳酸脱氢酶等7种血清酶水平,分析γ-谷胺酰转移酶、乳酸脱氢酶与临床特征关系差异表达。Cox比例风险模型分析血清酶与患者预后关系。结果肝癌、肝血管瘤、健康体检者中7种血清酶水平差异有统计学意义;巨块型肝癌(≥10cm)、合并门静脉癌栓患者γ-谷胺酰转移酶、乳酸脱氢酶水平较高,GGT、LDH是原发性肝癌的独立预后因素。结论乙肝相关性肝癌患者血清酶水平增高。高GGT、LDH生存期较短,是影响预后的独立危险因素,有助于临床筛选对TACE术获益的肝癌患者人群。

Objective To investigate the changes of serum enzymes before operation and the prognostic significance of TACE in patients with HBV-related hepatocellular carcinoma. Methods The serum samples of 80 patients with hepatocellular carcinoma complicated with hepatitis B infection treated by TACE from December 2013 to December 2018 were collected, including 80 patients with hepatic hemangioma, 32 patients with hepatic hemangioma and 32 healthy controls. Rank sum test was used to compare seven serum enzymes including ALP, GGT, AFU, CHE, ALT, AST, and LDH. The differential expression of GGT and LDH in relation to clinical characteristics was analyzed. Results The levels of seven serum enzymes in patients with hepatocellular carcinoma, hepatic hemangioma and health examination were significantly different. The levels of GGT and LDH were higher in patients with massive hepatocellular carcinoma( ≥ 10 cm) and portal vein cancer thrombus. GGT and LDH were independent prognostic factors of primary hepatocellular carcinoma. Conclusion The level of serum enzymes in patients with HBV-related hepatocellular carcinoma was significantly higher than that in normal subjects. High serum GGT and LDH levels have a short survival time, which is an independent risk factor affecting prognosis. It is helpful for clinical screening of patients with hepatocellular carcinoma who benefit from TACE.