[1]隰子涵,杨永波,邵国良.MRI和临床危险因素对中晚期肝细胞癌首次D-TACE近期疗效预测价值分析[J].介入放射学杂志,2024,33(04):376-381.
　XI Zihan,YANG Yongbo,SHAO Guoliang..The value of MRI and clinical risk factors in predicting the short-term efficacy of initial D-TACE in patients with intermediate and advanced stage hepatocellular carcinoma[J].journal interventional radiology,2024,33(04):376-381.
点击复制

MRI和临床危险因素对中晚期肝细胞癌首次D-TACE近期疗效预测价值分析()

PDF下载中关闭

分享到：

《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
33
期数:
2024年04
页码:
376-381
栏目:
肿瘤介入
出版日期:
2024-05-04

文章信息/Info

Title:
The value of MRI and clinical risk factors in predicting the short-term efficacy of initial D-TACE in patients with intermediate and advanced stage hepatocellular carcinoma
作者:
隰子涵;  杨永波;  邵国良
Author(s):
XI Zihan;  YANG Yongbo;  SHAO Guoliang.
Department of Radiology， Zhejiang Provincial Cancer Hospital， Hangzhou， Zhejiang Province 310005， China
关键词:
【关键词】 肝细胞癌;  药物洗脱微球;  经导管动脉化疗栓塞术;  多参数磁共振成像;  无疾病进展期
文献标志码:
A
摘要:
【摘要】 目的 探讨肝细胞癌（HCC）患者术前增强MRI影像学特征及相关临床资料与首次药物洗脱微球- 经导管动脉化疗栓塞术（D- TACE）近期疗效的关系。方法 回顾性分析113例中晚期HCC患者临床及MRI影像学资料。依据近期疗效分为客观缓解（OR）组（n=74）和非OR组（n=39）。采用单因素及多因素logistic回归分析筛选出与D- TACE近期疗效相关的独立因素。采用Kaplan- Meier法计算无疾病进展期（PFS），Log- rank检验反映近期疗效与PFS关系。通过Cox比例风险回归确定与PFS相关影响因素。结果 多因素logistic回归分析结果显示，前白蛋白低（OR=1.012，P=0.029）、载药量多（OR=0.969，P=0.016）、肿瘤/肝脏体积比高（OR=0.001，P=0.007）、肿瘤边缘强化程度重（OR=0.239，P=0.049）与首次D- TACE近期疗效显著相关。OR组、非OR组中位PFS分别为8.5个月、4.5个月，OR组预后更佳（χ2=4.903，P=0.027）。Cox比例风险回归分析显示首次D- TACE近期疗效好、肿瘤最大径大、肿瘤/肝脏体积比小是PFS保护因素。结论 HCC患者肿瘤/肝脏体积比低、前白蛋白高、载药量少、肿瘤边缘强化程度轻，首次D- TACE近期疗效更可能达到OR，PFS更长。

参考文献/References:

［1］ Sung H， Ferlay J， Siegel RL， et al. Global cancer statistics 2020： GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries［J］. CA Cancer J Clin， 2021， 71： 209- 249.
［2］ Reig M， Forner A， Rimola J， et al. BCLC strategy for prognosis prediction and treatment recommendation： the 2022 update［J］. J Hepatol， 2022， 76： 681- 693.
［3］ Wei G， Yang J. Advances in the treatment of hepatocellular carcinoma using drug- eluting beads［J］. J Interv Med， 2020， 3： 122- 127.
［4］ Lee BC， Jeong YY， Heo SH， et al. Gadoxetic acid- enhanced MRI features for predicting treatment outcomes of early hepatocellular carcinoma（＜3 cm） after transarterial chemoembolization［J］. Acad Radiol， 2022， 29： e178- e188.
［5］ Lee JY， Lee BC， Kim HO， et al. Liver MRI and clinical findings to predict response after drug eluting bead transarterial chemoembolization in hepatocellular carcinoma［J］. Sci Rep， 2021， 11： 24076.
［6］ Calderaro J， Ziol M， Paradis V， et al. Molecular and histological correlations in liver cancer［J］. J Hepatol， 2019， 71： 616- 630.
［7］ Zhu HD，Li HL，Huang MS，et al. Transarterial chemoembolization with PD- （L）1 inhibitors plus molecular targeted therapies for hepatocellular carcinoma（CHANCE001）［J］. Signal Transduct Target Ther， 2023， 8： 58.
［8］ 侯忠衡，张 磊，王 祁，等． 术前血清前白蛋白对TACE治疗不可切除肝细胞癌患者预后的预测价值［J］． 介入放射学杂志， 2022， 31：587- 592．
［9］ Wen XJ， Yao MJ， Lu YW， et al. Integration of prealbumin into Child- Pugh classification improves prognosis predicting accuracy in HCC patients considering curative surgery［J］. J Clin Transl Hepatol， 2018， 6： 377- 384.
［10］ Saito M， Seo Y， Yano Y， et al. Short- term reductions in non- protein respiratory quotient and prealbumin can be associated with the long- term deterioration of liver function after transcatheter arterial chemoembolization in patients with hepatocellular carcinoma［J］. J Gastroenterol， 2012， 47： 704- 714.
［11］ Lee SY， Ou HY， Yu CY， et al. Drug- eluting bead transarterial chemoembolization for hepatocellular carcinoma： does size really matter?［J］. Diagn Interv Radiol， 2020， 26： 230- 235.
［12］ Prajapati HJ， Xing M， Spivey JR， et al. Survival， efficacy， and safety of small versus large doxorubicin drug- eluting beads TACE chemoembolization in patients with unresectable HCC［J］. AJR Am J Roentgenol， 2014， 203： W706- W714.
［13］ Lin CY， Liu YS， Pan KT， et al. The short- term safety and efficacy of TANDEM microspheres of various sizes and doxorubicin loading concentrations for hepatocellular carcinoma treatment［J］. Sci Rep， 2021， 11： 12277.
［14］ Malagari K， Kiakidis T， Pomoni M， et al. Pharmacokinetics， safety， and efficacy of chemoembolization with doxorubicin- loaded tightly calibrated small microspheres in patients with hepatocellular carcinoma［J］. Cardiovasc Intervent Radiol， 2016， 39： 1379- 1391.
［15］ Min JH， Lee MW， Park HS， et al. Interobserver variability and diagnostic performance of gadoxetic acid- enhanced MRI for predicting microvascular invasion in hepatocellular carcinoma［J］. Radiology， 2020， 297： 573- 581.
［16］ Kuang DM， Peng C， Zhao Q， et al. Activated monocytes in peritumoral stroma of hepatocellular carcinoma promote expansion of memory T helper 17 cells［J］. Hepatology， 2010， 51： 154- 164.
［17］ Chen DP，Ning WR，Li XF，et al. Peritumoral monocytes induce cancer cell autophagy to facilitate the progression of human hepatocellular carcinoma［J］. Autophagy， 2018， 14： 1335- 1346.
［18］ Kim BK， Kim SU， Kim KA， et al. Complete response at first chemoembolization is still the most robust predictor for favorable outcome in hepatocellular carcinoma［J］. J Hepatol， 2015， 62： 1304- 1310.
［19］ Chen M， Cao J， Hu J， et al. Clinical- radiomic analysis for pretreatment prediction of objective response to first transarterial chemoembolization in hepatocellular carcinoma［J］. Liver Cancer， 2021， 10： 38- 51.
［20］ Wang Q， Xia D， Bai W， et al. Development of a prognostic score for recommended TACE candidates with hepatocellular carcinoma： a multicentre observational study［J］. J Hepatol， 2019， 70： 893- 903.

相似文献/References:

[1]姚雪松,李 槐.不可手术切除的肝细胞癌的疗效评价标准——改良ＲＥＣＩＳＴ标准更可靠[J].介入放射学杂志,2012,(03):177.
　. Ｔｈｅｒａｐｅｕｔｉｃ ｅｖａｌｕａｔｉｏｎ ｃｒｉｔｅｒｉｏｎ ｏｆ ｉｎｏｐｅｒａｂｌｅ ｈｅｐａｔｏｃｅｌｌｕｌａｒ ｃａｒｃｉｎｏｍａｓ： ｍｏｄｉｆｉｅｄ ＲＥＣＩＳＴ ａｓ ａ ｍｏｒｅ ｒｅｌｉａｂｌｅ ｓｔａｎｄａｒｄ[J].journal interventional radiology,2012,(04):177.
[2]梁茂全,苏洪英. 肝癌化疗栓塞前后甲胎蛋白变化模式的临床意义[J].介入放射学杂志,2012,(04):333.
　.Ｔｈｅ ｔｒａｎｓｆｏｒｍａｔｉｏｎ ｐａｔｔｅｒｎ ｏｆ ｓｅｒｕｍ аｆｅｔｏｐｒｏｔｅｉｎ ａｆｔｅｒ ｔｒａｎｓｃａｔｈｅｔｅｒ ａｒｔｅｒｉａｌ ｃｈｅｍｏｅｍｂｏｌｉｚａｔｉｏｎ ｉｎ ｐａｔｉｅｎｔｓ ｗｉｔｈ ｈｅｐａｔｏｃｅｌｌｕｌａｒ ｃａｒｃｉｎｏｍａ： ｉｔｓ ｃｌｉｎｉｃａｌ ｓｉｇｎｉｆｉｃａｎｃｅ [J].journal interventional radiology,2012,(04):333.
[3]孙 磊,施海彬,刘 圣,等.肝细胞癌肝动脉门静脉分流形成的相关因素分析[J].介入放射学杂志,2012,(03):206.
　,,et al.Ｔｈｅ ｆａｃｔｏｒｓ ｒｅｌａｔｅｄ ｔｏ ｔｈｅ ｆｏｒｍａｔｉｏｎ ｏｆ ａｒｔｅｒｉｏｐｏｒｔａｌ ｓｈｕｎｔｉｎｇ ｉｎ ｐａｔｉｅｎｔｓ ｗｉｔｈ ｈｅｐａｔｏｃｅｌｌｕｌａｒ ｃａｒｃｉｎｏｍａｓ [J].journal interventional radiology,2012,(04):206.
[4]沈海洋,刘瑞宝,刘 岩,等. 肝右叶前、后段原发性肝癌TACE后VEGF及CD34的表达水平 ；[J].介入放射学杂志,2012,(06):469.
　SHEN Hai- yang,LIU Rui- bao,LIU Yan,et al. The expression levels of vascular endothelial growth factor and CD34 in residual cancerous tissues of primary hepatocellular carcinoma located at anterior and posterior segments of right lobe liver after TACE[J].journal interventional radiology,2012,(04):469.
[5]李晓峰,钱国军,张 磊,等. 微波高功率条件下消融原发性肝癌的初步研究[J].介入放射学杂志,2011,(12):974.
　LI Xiao-feng,QIAN Guo-jun,ZHANG Lei,et al.Microwave ablation with high output power for the treatment of hepatocellular carcinoma: a preliminary study[J].journal interventional radiology,2011,(04):974.
[6]彭辽河,胡晓燕,李 杰,等. 18F-FDG PET/CT显像在肝细胞癌TACE术后残留或复发病灶检出中的应用价值[J].介入放射学杂志,2012,(08):636.
　PENG Liao- he,HU Xiao- yan,LI Jie,et al. Clinical application of 18F- FDG PET/CT imaging in detecting residual lesions or recurrence foci of hepatocellular carcinoma after TACE treatment[J].journal interventional radiology,2012,(04):636.
[7]陆小华,朱小庆,茅国新.肝细胞癌相关单核苷酸多态性的研究进展[J].介入放射学杂志,2013,(06):520.
　LU Xiao? hua,ZHU Xiao? qing,MAO Guo? xin.. Hepatocellular carcinoma?蛳 related single nucleotide polymorphisms： recent advances in research[J].journal interventional radiology,2013,(04):520.
[8]姚雪松,闫 东,曾辉英,等.TACE联合索拉非尼治疗不能手术切除肝细胞癌介入治疗间隔时间的分析[J].介入放射学杂志,2014,(09):769.
　YAO Xue song,YAN Dong,ZENG Hui ying,et al.TACE combined with sorafenib for inoperable hepatocellular carcinoma： analysis of treatment interval[J].journal interventional radiology,2014,(04):769.
[9]姚雪松,闫 东,曾辉英,等. TACE联合索拉非尼治疗不能手术切除肝细胞肝癌50例[J].介入放射学杂志,2013,(05):381.
　YAO Xue? song,YAN Dong,ZENG Hui? ying,et al. Ttransarterial chemoembolization combined with sorafenib for inoperable hepatocellular carcinoma： a clinical analysis of 50 cases[J].journal interventional radiology,2013,(04):381.
[10]赵 松,陈学春,龙清云,等. 经肝动脉化疗栓塞联合射频消融治疗肝细胞癌疗效荟萃分析[J].介入放射学杂志,2013,(11):908.
　ZHAO Song,CHEN Xue? chun,LONG Qing? yun,et al. Transcatheter arterial chemoembolization combined with radiofrequency ablation for the treatment of hepatocellular carcinoma： a systematic review and Meta analysis[J].journal interventional radiology,2013,(04):908.
[11]夏子聪,赵 辉.改善经导管动脉化疗栓塞术疗效的临床及基础研究进展[J].介入放射学杂志,2023,32(07):705.
　XIA Zicong,ZHAO Hui..Advances in clinical and fundamental researches for improving the efficacy of transcatheter arterial chemoembolization[J].journal interventional radiology,2023,32(04):705.

备注/Memo

备注/Memo:
（收稿日期：2023- 08- 01）
（本文编辑：谷 珂）
更新日期/Last Update: 2024-05-04