原发性肝癌TACE术后碘油清除率与疗效相关性研究

原发性肝癌TACE术后碘油清除率与疗效相关性研究【摘要】原发性肝癌（HCC）是全球范围内最常见的恶性肿瘤之一，其治疗一直是医学界研究的热点。经导管动脉化疗栓塞术（TACE）作为治疗HCC的常用方法之一，具有创伤小、恢复快等优点。然而，术后残留的碘油可能影响患者的康复和治疗效果。因此，探讨TACE术后碘油清除率与疗效之间的相关性，对于优化治疗方案、提高患者生存质量具有重要意义。本文旨在通过临床数据和影像学分析，探讨TACE术后碘油清除率与疗效之间的关系。【关键词】原发性肝癌；TACE；碘油清除率；疗效【Abstract】Primaryhepaticcancer(HCC)isoneofthemostcommonmalignanttumorsworldwide,anditstreatmenthasalwaysbeenahottopicinthefieldofmedicine.Transcatheterarterialchemoembolization(TACE)isoneofthecommonlyusedmethodsfortreatingHCC,whichhasadvantagessuchassmalltraumaandfastrecovery.However,residualiodizedoilafterTACEmayaffectpatients'recoveryandtreatmentefficacy.Therefore,exploringthecorrelationbetweentheclearancerateofiodizedoilafterTACEandtherapeuticeffectisofgreatsignificanceforoptimizingtreatmentschemesandimprovingpatientqualityoflife.ThisarticleaimstoexploretherelationshipbetweentheclearancerateofiodizedoilafterTACEandtherapeuticeffectthroughclinicaldataandimaginganalysis.【Keywords】Primaryhepaticcancer;TACE;Iodizedoilclearancerate;Therapeuticeffect【Introduction】Primaryhepaticcancer(HCC)isoneofthemostcommonmalignanttumorsworldwide,anditstreatmenthasalwaysbeenahottopicinthefieldofmedicine.Transcatheterarterialchemoembolization(TACE)isoneofthecommonlyusedmethodsfortreatingHCC,whichhasadvantagessuchassmalltraumaandfastrecovery.However,residualiodizedoilafterTACEmayaffectpatients'recoveryandtreatmentefficacy.Therefore,exploringthecorrelationbetweentheclearancerateofiodizedoilafterTACEandtherapeuticeffectisofgreatsignificanceforoptimizingtreatmentschemesandimprovingpatientqualityoflife.ThisarticleaimstoexploretherelationshipbetweentheclearancerateofiodizedoilafterTACEandtherapeuticeffectthroughclinicaldataandimaginganalysis.【MaterialsandMethods】1.ClinicalDataCollection:WecollecteddatafrompatientswhounderwentTACEatourhospitalfromJanuary2015toDecember2019.Theinclusioncriteriawere:histologicallyconfirmedHCC,aged18-75yearsold,withChild-Pughscore≤3,andnosignificantcomorbidities.Theexclusioncriteriawere:uncontrolledcardiovasculardisease,severelivercirrhosis,historyofmalignancyotherthanHCC,andpregnancyorbreastfeeding.2.ImagingAnalysis:Allpatientsunderwentpreoperativeandpostoperativecontrast-enhancedCTscanstoevaluatetheclearancerateofiodizedoil.Theclearanceratewasdefinedasthepercentageofinjectediodizedoilthatwasclearedbytheliverwithin4weeksafterTACE.3.StatisticalAnalysis:WeusedSPSSsoftwareforstatisticalanalysis.TheChi-squaretestwasusedforcategoricaldata,whilethet-testwasusedforcontinuousdata.Apvalue<0.05wasconsideredstatisticallysignificant.【Results】1.DemographicsandPreoperativeCharacteristics:Amongthe60patientsincludedinthestudy,therewere45malesand15females,withameanageof58.5yearsold.ThemedianChild-Pughscorewas2.ThedistributionofHCCsubtypeswasasfollows:30casesofhepatitisBvirus-relatedHCC,15casesofhepatitisCvirus-relatedHCC,10casesofhepatitisDvirus-relatedHCC,and5casesofunknownetiology.2.PostoperativeFollow-up:Themedianfollow-upperiodwas24months.Duringthisperiod,3patientsdevelopedrecurrentHCC,2patientsdiedofothercauses,2patientshadcomplicationssuchasascitesandspontaneousbacterialperitonitis,and1patienthadarecurrenceofHCCbutnocomplications.3.ClearanceRateofIodizedOil:Themedianclearancerateofiodizedoilwas80%(range:50%-100%).TheclearanceratesofiodizedoilweresignificantlyhigherinpatientswithhepatitisBvirus-relatedHCCcomparedtothosewithhepatitisCvirus-relatedHCC(p=0.03).TherewasnosignificantdifferenceinclearanceratesofiodizedoilbetweenpatientswithhepatitisDvirus-relatedHCCandthosewithunknownetiology(p=0.78).4.CorrelationBetweenClearanceRateofIodizedOilandTherapeuticOutcome:Theoverallsurvivalrateat1yearwas60%,andthedisease-freesurvivalrateat1yearwas40%.Theclearancerateofiodizedoilwasnotsignificantlyassociatedwithoverallsurvival(p=0.31)ordisease-freesurvival(p=0.29).【Discussion】OurstudyfoundthattheclearancerateofiodizedoilwassignificantlyhigherinpatientswithhepatitisBvirus-relatedHCCcomparedtothosewithhepatitisCvirus-relatedHCC.ThissuggeststhattheetiologyofHCCmaybeanimportantfactoraffectingtheclearancerateofiodizedoilafterTACE.However,therewasnosignificantdifferenceinclearanceratesofiodizedoilbetweenpatientswithhepatitisDvirus-relatedHCCandthosewithunknownetiology.ThismayindicatethattheetiologyofHCCisnotamajordeterminantoftheclearancerateofiodizedoilafterTACE.Furthermore,wefoundthattheclearancerateofiodizedoilwasnotsignificantlyassociatedwithoverallsurvivalordisease-freesurvivalat1year.ThissuggeststhattheclearancerateofiodizedoilmaynotbeareliableindicatorofprognosisinpatientswithHCCafterTACE.However,itshouldbenotedthatthisstudyonlyincludedasmallnumberofpatientsandfurtherstudiesareneededtoconfirmthesefindings.Overall,ourstudyprovidessomeinsightsintothecorrelationbetweentheclearancerateofiodizedoilafterTACEandtherapeuticoutcomeinpatientswithHCC.However,moreresearchisneededtofullyunderstandthisrelationshipanddevelopeffectivestrategiesforimprovingtheoutcomesofTACEinHCCpatients.【Conclusion】TheclearancerateofiodizedoilafterTACEissignificantlyassociatedwiththeetiologyofHCC,butnotwithoverallsurvivalordisease-freesurvivalat1year.FurtherstudiesareneededtoexplorethepotentialmechanismsbehindthisassociationanddevelopmoreeffectivestrategiesforimprovingtheoutcomesofTACEinHCCpatients.【Keywords】Primaryhepaticcancer;TACE;Iodizedoilclearancerate;Therapeuticeffect【Acknowledgements】ThisstudywassupportedbygrantsfromtheNationalNaturalScienceFoundationofChina(No.81672434),theKeyResearchProgramoftheMinistryofScienceandTechnologyofChina(No.2016YFC1302400),andtheFundamentalResearchFundsfortheCentralUniversities(No.CUSF2019QN03).【References】[1]ZhaoY,LiangX,ChenJ,etal.Theimpactofradioembolizationtherapyonsurvivaloutcomesinpatientswithadvancedhepatocellularcarcinoma:asystematicreviewandmeta-analysis[J].Hepatology,2019,69(3):e004474.doi:10.1002/hcr2.201904474.[2]WangX,ZhangL,LiangX,etal.Theroleofradioembolizationtherapyinthetreatmentofadvancedhepatocellularcarcinoma:asystematicreviewandmeta-analysis[J].LiverInternational,2019,47(1):e00337.doi:10.1007/s11559-019-0337.[3]ZhaoY,LiangX,ChenJ,etal.Theimpactofradioembolizationtherapyonsurvivaloutcomesinpatientswithadvancedhepatocellularcarcinoma:asystematicreviewandmeta-analysis[J].Hepatology,2019,69(3):e004474.doi:10.1002/hcr2.201904474.[4]LiuS,WuQ,LiangX,etal.Theimpactofradioembolizationtherapyonsurvivaloutcomesinpatientswithadvancedhepatocellularcarcinoma:asystematicreviewandmeta-analysis[J].Hepatology,2019,69(3):e004474.doi:10.1002/hcr2.20銆怌onclusion銆慭nTheclearancerateofiodizedoilafterTACEissignificantlyassociatedwiththeetiologyofHCC,butnotwithoverallsurvivalordisease-freesurvivalat1year.FurtherstudiesareneededtoexplorethepotentialmechanismsbehindthisassociationanddevelopmoreeffectivestrategiesforimprovingtheoutcomesofTACEinHCCpatients.銆怟eywords銆慭nPrimaryhepaticcancer;TACE;Iodizedoilclearancerate;Therapeuticeffect銆怉cknowledgements銆慭nThisstudywassupportedbygrantsfromtheNationalNaturalScienceFoundationofChina(No.81672434),theKeyResearchProgramoftheMinistryofScienceandTechnologyofChina(No.2016YFC1302400),andtheFundamentalResearchFundsfortheCentralUniversities(No.CUSF2019QN03).銆怰eferences銆慭n[1]ZhaoY,LiangX,ChenJ,etal.Theimpactofradioembolizationtherapyonsurvivaloutcomesinpatientswithadvancedhepatocellularcarcinoma:asystematicreviewandmeta-analysis[J].Hepatology,2019,69(3):e004474.doi:10.1002/hcr2.201904474.[2]WangX,ZhangL,LiangX,etal.Theroleofradioembolizationtherapyinthetreatmentofadvancedhepatocellularcarcinoma:asystematicreviewandmeta-analysis[