CAJ | 학술논문

目的:探讨行TACE治疗肝癌患者血清乳酸脱氢酶水平与预后的关系.方法:分析山东省肿瘤医院2005年2月至2009年2月行肝动脉化疗栓塞术(transarterial chemoembolization,TACE)治疗的145例中晚期肝癌患者临床资料和实验室数据,分别于术前和术后1个月内监测乳酸脱氢酶的水平.结果:据术前血清乳酸脱氢酶浓度,将患者分为两组,对照组(LDH≤450 U/L)86例和观察组(LDH>450 U/L)59例.对照组平均疾病进展时间(TTP)和总生存期(OS)分别为14.2个月和19.3个月,观察组患者TTP和OS分别为9.1个月和11.2个月,两组患者TTP和OS差异有统计学意义(P<0.05).治疗后64例患者LDH值下降,其TTP和OS分别为11.3和18.8个月,而术后81例患者LDH水平升高,其TTP和OS分别为9.1和9.8个月,两组患者TTP和OS差异有统计学意义(P<0.05).结论:初诊患者血清乳酸脱氢酶活性检测能够预测行TACE肝癌患者的临床疗效,术前高LDH水平患者可能在TACE和抑制肿瘤血管生成的综合治疗方法中受益,可提高TTP和OS.
목적:탐토행TACE치료간암환자혈청유산탈경매수평여예후적관계.방법:분석산동성종류의원2005년2월지2009년2월행간동맥화료전새술(transarterial chemoembolization,TACE)치료적145례중만기간암환자림상자료화실험실수거,분별우술전화술후1개월내감측유산탈경매적수평.결과:거술전혈청유산탈경매농도,장환자분위량조,대조조(LDH≤450 U/L)86례화관찰조(LDH>450 U/L)59례.대조조평균질병진전시간(TTP)화총생존기(OS)분별위14.2개월화19.3개월,관찰조환자TTP화OS분별위9.1개월화11.2개월,량조환자TTP화OS차이유통계학의의(P<0.05).치료후64례환자LDH치하강,기TTP화OS분별위11.3화18.8개월,이술후81례환자LDH수평승고,기TTP화OS분별위9.1화9.8개월,량조환자TTP화OS차이유통계학의의(P<0.05).결론:초진환자혈청유산탈경매활성검측능구예측행TACE간암환자적림상료효,술전고LDH수평환자가능재TACE화억제종류혈관생성적종합치료방법중수익,가제고TTP화OS.
Objective: This study aims to investigate the relationship between serum lactate dehydrogenase (LDH) levels and prognosis in the course of transarterial chemoembolization (TACE) of primary liver cancer (PLC). Methods:Clinical and laboratory da-ta of 145 consecutive patients undergoing trans-arterial chemo-embolization of unresectable PLC from February 2005 to February 2009 were analyzed. LDH values were obtained from the patients a month before the procedure. Results:The patients were divided into two groups according to the concentration of the LDH serum registered before TACE (first:LDH<450, U/L 86 patients;second:LDH>450, U/L 59 patients). The patients were also classified according to the variation in the LDH serum levels before and after treatment (in-creased:81 patients versus decreased:64 patients). The median time to progression (TTP) was 14.2 months for patients with LDH val-ues below 450 U/L, whereas median TTP was 9.1 months for patients with LDH values above the cut-off (P=0.000). The median over-all survival (OS) was 19.3 months and 11.2 months (P=0.000). Median TTP was 11.3 months and median OS was 18.8 months for pa-tients with decreased LDH values after treatment, whereas median TTP was 9.1 months and median OS was 9.8 months for patients with increased LDH levels (TTP:P=0.001;OS:P=0.004). Conclusions:LDH is able to predict the clinical outcome for HCC patients undergoing TACE. High LDH pretreatment levels may be suitable candidates for clinical exploration in a multimodality treatment ap-proach with TACE and anti-VEGF inhibitors to improve TTP and OS.