乙型肝炎相关性原发性肝癌经导管肝动脉化疗栓塞术后早期复发情况及危险因素分析

Analysis of risk factors for early recurrence of hepatitis B-associated primary hepatic cancer after transcatheter arterial chemoembolization

目的探讨乙型肝炎相关性原发性肝癌经导管肝动脉化疗栓塞(TACE)术后早期复发情况及危险因素。方法纳入2019年1月至2023年3月郑州大学第一附属医院收治的102例乙型肝炎相关性原发性肝癌患者初次TACE术前临床资料,根据随访1 a内是否复发将患者分为复发组和未复发组,分析肝癌复发的独立危险因素。结果102例TACE术后患者1 a内复发48例,复发率为47.1%。复发组与未复发组患者乙型肝炎病毒(HBV)DNA、谷丙转氨酶(ALT)、甲胎蛋白(AFP)、肿瘤最大直径、肿瘤数目比较差异均有统计学意义(χ^(2)=12.459,P<0.001;χ^(2)=4.253,P<0.001;χ^(2)=4.351,P<0.001;χ^(2)=5.993,P<0.001;χ^(2)=5.508,P<0.001)。多因素Logistic回归分析结果示,ALT、AFP、肿瘤最大直径、肿瘤数目是乙型肝炎相关性原发性肝癌患者TACE术后早期复发的独立危险因素(OR=1.085,P=0.037;OR=1.117,P=0.004;OR=1.151,P=0.020;OR=11.580,P=0.044)。结论乙型肝炎相关性原发性肝癌TACE术后患者复发风险较高,独立危险因素包括ALT、AFP、肿瘤最大直径、肿瘤数目,临床上应密切检测相关指标,若有异常及时进行干预,预防术后肝癌的复发。

Objective To study the early recurrence and independent risk factors of hepatitis B-associated primary hepatic cancer after transcatheter arterial chemoembolization(TACE)therapy.Methods From January 2019 to March 2023,102 patients with hepatitis B-associated primary hepatic cancer who were treated with TACE for the first time in the First Affiliated Hospital of Zhengzhou University were included.The patients were divided into the recurrence group and the non-recurrence group according to whether they recurred within 1 year of follow-up,and the independent risk factors of hepatic cancer recurrence were analyzed according to their clinical data.Results In the 102 patients after TACE,48 patients recurred within 1 year,and the recurrence rate was 47.1%.There were significant differences in the hepatitis B virus(HBV)DNA,alanine transaminase(ALT),alpha\|fetoprotein(AFP),tumor maximum diameter and tumor number between the recurrent group and the non-recurrent group(χ^(2)=12.459,P<0.001;χ^(2)=4.253,P<0.001;χ^(2)=4.351,P<0.001;χ^(2)=5.993,P<0.001;χ^(2)=5.508,P<0.001).Multivariate Logistic regression analysis showed that ALT,AFP,maximum tumor diameter and tumor number were the independent risk factors for recurrence after TACE(OR=1.085,P=0.037;OR=1.117,P=0.004;OR=1.151,P=0.020;OR=11.580,P=0.044).Conclusion The recurrence rate of patients with hepatitis B-associated primary hepatic cancer after TACE is higher.Independent risk factors include ALT,AFP,maximum tumor diameter,and number of tumors.Relevant indicators of patients with primary hepatic cancer after TACE should be closely detected.Timely clinical treatment should be carried out to prevent the recurrence.