不同阶段血浆D-二聚体水平在原发性肝癌患者栓塞化疗预后评估中的预测价值

Predictive Value of Plasma D-dimer Levels at Different Stages in the Prognostic Evaluation of Embolization Chemotherapy in Patients with Primary Liver Cancer

目的:探讨原发性肝癌(PLC)患者经导管动脉化疗栓塞(TACE)不同阶段血浆D-二聚体(D-D)水平对患者预后的影响。方法:选取2014年9月-2018年6月因PLC于本院行经导管动脉化疗栓塞(TACE)治疗患者共90例,根据TACE的治疗效果分为控制组(n=48)和进展组(n=42),对比两组TACE治疗前1周(D0)、术后1 d(D1)、治疗后2周(D2)、治疗后1个月(D3)血浆D-D水平,记录所有患者的无进展存活期(PFS)。结果:控制组PT时间显著短于进展组,差异有统计学意义(P<0.05)。进展组D2、D3血浆D-D水平均显著高于控制组,差异均有统计学意义(P<0.05)。D3血浆D-D增加患者TACE术后PFS显著短于血浆D-D下降患者[(13.23±2.03)个月vs(26.11±3.13)个月,P<0.05]。结论:术后1个月PLC患者的血浆D-D水平在评估和预测TACE疗效和预后中起一定作用,术后1个月D-D增加是PLC患者TACE治疗预后不良的重要因素。

Objective:To investigate the effect on prognosis of plasma D-dimer(D-D)levels at different stages for primary liver cancer(PLC)with transcatheter arterial chemoembolization(TACE).Method:A total of 90 patients who underwent TACE in our hospital from September 2014 to June 2018 were selected,they were divided into the control group(n=48)and the progression group(n=42)according to the effect of TACE.The plasma D-D levels between two groups at 1 week before surgery(D0),1 day after surgery(D1),2 weeks after treatment(D2),and 1 month after treatment(D3)were compared.Progression-free survival time(PFS)of all patients were recorded.Result:The PT time of the control group was significantly shorter than that of the progress group,and the difference was statistically significant(P<0.05).The plasma D-D levels at D2 and D3 in the progress group were significantly higher than those in the control group,and the differences were statistically significant(P<0.05).Patients with increased plasma D-D at D3 after TACE had significantly shorter PFS compared with patients with decreased plasma D-D[(13.23±2.03)months vs(26.11±3.13)months,P<0.05].Conclusion:Plasma D-D level in PLC patients at 1 month after TACE plays a role in evaluating and predicting the efficacy and prognosis of TACE.The increase of D-dimer at 1 month after treatment is an important factor for the poor prognosis of TACE in PLC patients.