肝动脉插管栓塞化疗后原发性肝癌血清AFP浓度与疗效的关系

目的探讨肝动脉插管栓塞化疗后原发性肝癌血清AFP浓度与疗效的关系。方法对99例原发性肝癌患者行经肝动脉化疗栓塞术（transcatheter arterial chemoembolization,TACE）。在治疗前均常规行肝总动脉或腹腔动脉造影,选择性动脉插管至肿瘤供血动脉处,缓慢注入化疗药物[氟尿嘧啶1 000 mg、奥沙利铂100 mg、阿霉素30 mg＋碘化油10～30 mL（根据肿瘤大小决定）]进行乳化栓塞。采用电化学发光仪、使用化学发光法进行血清AFP测定。结果 99例患者中,TACE治疗后血清AFP〈200、≥200～〈1 000 ng.L-1有效率均明显高于TACE治疗后血清AFP≥1 000 ng.L-1（均P〈0.05）,TACE治疗后血清AFP〈200、≥200～〈1 000 ng.L-1转移率均明显低于TACE治疗后血清AFP≥1 000 ng.L-1（P〈0.05或P〈0.01）。结论 TACE治疗后血清AFP浓度的检测可反映原发性肝癌介入治疗后的疗效、预后及转移率。

Relationship between Serum Alpha-fetoprotein Levels and Efficacy of Transcatheter Arterial Chemoembolization in Primary Liver Cancer

Objective To explore the relationship between serum alpha-fetoprotein （AFP）levels and efficacy of transcatheter arterial chemoembolization （TACE）in primary liver cancer. Methods A total of 99 patients underwent TACE for primary liver cancer. Hepatic artery or celiac angiography was carried out before TACE. Selective arterial catheterization was performed via the feeding artery of the tumor and chemotherapy drugs [fluorouracil 1 000 mg, oxaliplatin 100 mg, and doxorubiein 30 mg ＋ iodized oil 10-30 mL （decision based on tumor size）]were slowly given by infusion. Serum AFP levels were measured by chemiluminescence using electrochemiluminescence instrument. Results Compared with patients with serum AFP levels ≥ 1 000 ng.L-1, effective rates significantly increased and metasta- sis rates obviously decreased in patients with serum AFP〈200 or ≥200-〈1 000 ng.L-1 after TACE（P〈 0.05 or P〈0.01）. Conclusion The detection of serum AFP levels can reflect the efficacy of interven- tional treatment, prognosis and metastasis rates in primary liver cancer after TACE.