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胡永, 陈一兴, 周永康, 等. 血清肿瘤坏死因子α水平对肝细胞肝癌患者放疗预后的影响[J]. 中国临床医学, 2022, 29(6): 926-931. DOI: 10.12025/j.issn.1008-6358.2022.20221138
引用本文: 胡永, 陈一兴, 周永康, 等. 血清肿瘤坏死因子α水平对肝细胞肝癌患者放疗预后的影响[J]. 中国临床医学, 2022, 29(6): 926-931. DOI: 10.12025/j.issn.1008-6358.2022.20221138
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HU Yong, CHEN Yi-xing, ZHOU Yong-kang, et al. Effect of serum tumor necrosis factor-α level on the outcome of patients with hepatocellular carcinoma after radiotherapy[J]. Chin J Clin Med, 2022, 29(6): 926-931. DOI: 10.12025/j.issn.1008-6358.2022.20221138
Citation: HU Yong, CHEN Yi-xing, ZHOU Yong-kang, et al. Effect of serum tumor necrosis factor-α level on the outcome of patients with hepatocellular carcinoma after radiotherapy[J]. Chin J Clin Med, 2022, 29(6): 926-931. DOI: 10.12025/j.issn.1008-6358.2022.20221138
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血清肿瘤坏死因子α水平对肝细胞肝癌患者放疗预后的影响

Effect of serum tumor necrosis factor-α level on the outcome of patients with hepatocellular carcinoma after radiotherapy

    摘要
  • 摘要:
    目的 探讨肝细胞肝癌患者放疗前血清肿瘤坏死因子α(tumor necrosis factor-α, TNF-α)水平与放疗疗效及预后之间的关系。
    方法 回顾性分析2016年10月至2021年6月在复旦大学附属中山医院接受放射治疗的103例肝细胞肝癌患者的临床资料。纳入患者肿瘤均局限于肝内，且放疗前进行血清TNF-α水平的检测。采用Kaplan-Meier法计算生存率；Cox比例风险回归模型分析影响患者预后的独立因素。
    结果 103例患者中，男性87例、女性16例，年龄28~83岁，中位年龄63岁；肝内肿瘤最大径0.8~13.3cm，肝内肿瘤累计最大径0.8~13.3cm。随访6.3~64.7个月，中位随访22.0个月。放疗前TNF-α＞10.2pg/mL组（n=31）和TNF-α≤10.2pg/mL组（n=72）患者照射野内肿瘤最佳疗效及客观缓解率差异无统计学意义，1年、2年、3年的总生存（overall survival, OS）率分别为79.5%、52.8%、43.9%和100.0%、84.4%、82.1%（P＜0.001）。放疗前TNF-α水平是影响患者总生存时间的独立因素（HR=3.137，95%CI1.437~6.848，P=0.004）。
    结论 放疗前TNF-α水平可能影响肝细胞肝癌患者的放疗预后。

     

    Abstract:
    Objective To explore the association between serum tumor necrosis factor-α (TNF-α) level before radiotherapy (RT) and the radiotherapy efficiency and prognosis of patients with hepatocellular carcinoma (HCC) after RT.
    Methods The clinical data of 103 patients with HCC who received RT in Zhongshan Hospital, Fudan University from October 2016 to June 2021 were retrospectively analyzed. For these patients, the tumors were confined to the liver and serum TNF-α level was tested before RT. The survival rate was calculated by Kaplan-Meier, and Cox proportional hazard regression model was used to analyze the independent factors affecting the prognosis of patients.
    Results 103 patients included 87 males and 16 females. The median age was 63 years, ranging from 28 to 83 years, the maximum diameter of intrahepatic tumors ranged from 0.8 to 13.3 cm, and the cumulative maximum diameter of intrahepatic tumors ranged from 0.8 to 13.3 cm. The median follow-up time was 22.0 months, ranging from 6.3 to 64.7 months. The 1-year, 2-year, and 3-year overall survival rates were 79.5%, 52.8%, 43.9% and 100.0%, 84.4%, 82.1% in patients with pre-RT TNF-α > 10.2 pg/mL (n=31) and TNF-α≤10.2 pg/mL (n=72). There was no significant difference in RT efficiency between the two groups. The overall survival time of the two groups was significantly different (P < 0.001). The hazard ratio of pre-RT TNF-α was 3.137 (95%CI 1.437-6.848, P=0.004).
    Conclusion Pre-RT serum TNF-α level may affect the prognosis of HCC patients after RT.

     

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