改良白蛋白-胆红素分级对经导管动脉化疗栓塞术联合免疫及抗血管生成药物治疗的Child-Pugh A级不可切除肝细胞癌患者预后的预测价值
目的 研究改良白蛋白-胆红素分级 (mALBI分级) 对经导管动脉化疗栓塞术 (TACE) 联合免疫及抗血管生成药物治疗 (以下简称靶免治疗) 的Child-Pugh A级的不可切除肝细胞癌患者预后的评估价值。 方法 回顾性分析2020年1月—2023年1月在苏州大学附属第一医院和温州医科大学附属第五医院符合纳排标准的76例接受TACE联合靶免治疗的Child-Pugh A级不可切除肝细胞癌患者的资料，根据mALBI分级将其分为mALBI 1/2a组 (n=38) 和2b组 (n=38) 。主要研究终点为总生存期 (OS) ，次要研究结局为无进展生存期 (PFS) 、客观缓解率 (ORR) 、...
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| Published in | Linchuang gandanbing zazhi Vol. 40; no. 12; pp. 2450 - 2456 |
|---|---|
| Main Authors | , , , , , |
| Format | Journal Article |
| Language | Chinese |
| Published |
Changchun
Journal of Clinical Hepatology
01.12.2024
苏州大学附属第一医院介入科,江苏 苏州 215000 |
| Subjects | |
| Online Access | Get full text |
| ISSN | 1001-5256 2097-3497 |
| DOI | 10.12449/JCH241215 |
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| Abstract | 目的 研究改良白蛋白-胆红素分级 (mALBI分级) 对经导管动脉化疗栓塞术 (TACE) 联合免疫及抗血管生成药物治疗 (以下简称靶免治疗) 的Child-Pugh A级的不可切除肝细胞癌患者预后的评估价值。 方法 回顾性分析2020年1月—2023年1月在苏州大学附属第一医院和温州医科大学附属第五医院符合纳排标准的76例接受TACE联合靶免治疗的Child-Pugh A级不可切除肝细胞癌患者的资料，根据mALBI分级将其分为mALBI 1/2a组 (n=38) 和2b组 (n=38) 。主要研究终点为总生存期 (OS) ，次要研究结局为无进展生存期 (PFS) 、客观缓解率 (ORR) 、疾病控制率 (DCR) 。评估标准包括完全缓解、部分缓解、疾病稳定以及疾病进展。符合正态分布的计量资料组间比较采用成组t检验，不符合正态分布的计量资料组间比较采用Wilcoxon秩和检验。计数资料两组间比较采用χ2检验。Kaplan-Meier法绘制生存曲线，Log-rank检验比较组间中位生存期 (mOS) 和中位无进展生存期 (mPFS) 。采用单因素和多因素Cox比例风险模型分析影响患者预后的因素。 结果 2组患者的Alb水平、肿瘤负荷情况比较，差异均有统计学意义 (P值均<0.05) 。76例患者的mOS为25.2 (95%CI：18.4～32.0) 个月，mPFS为9.4 (95%CI：7.1～11.7) 个月，ORR为63.2%，DCR为82.9%。其中mALBI 1/2a组和2b组患者mOS分别为30.1 (95%CI：19.8～40.4) 个月和19.5 (95%CI：7.1～31.9) 个月，两组mOS差异有统计学意义 (χ2=4.490，P=0.034) 。mALBI 1/2a组和2b组患者mPFS分别为10.2 (95%CI：8.4～12.0) 个月和7.6 (95%CI：4.6～10.6) 个月，ORR分别为71.1%和55.3%，DCR分别为86.8%和78.9%，mPFS、ORR和DCR比较，差异均无统计学意义 (P值均>0.05) 。ECOG评分、肿瘤负荷、mALBI分级、门静脉侵犯和肝外转移是影响TACE联合靶免治疗患者mOS的独立危险因素 (P值均<0.05) 。没有发生与治疗相关的死亡。 结论 mALBI分级对预测TACE联合靶免治疗的Child-Pugh A级不可切除肝细胞癌患者的生存有 |
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| AbstractList | 目的 研究改良白蛋白-胆红素分级(mALBI分级)对经导管动脉化疗栓塞术(TACE)联合免疫及抗血管生成药物治疗(以下简称靶免治疗)的Child-Pugh A级的不可切除肝细胞癌患者预后的评估价值.方法 回顾性分析2020年1月—2023年1月在苏州大学附属第一医院和温州医科大学附属第五医院符合纳排标准的76例接受TACE联合靶免治疗的Child-Pugh A级不可切除肝细胞癌患者的资料,根据mALBI分级将其分为mALBI 1/2a组(n=38)和2b组(n=38).主要研究终点为总生存期(OS),次要研究结局为无进展生存期(PFS)、客观缓解率(ORR)、疾病控制率(DCR).评估标准包括完全缓解、部分缓解、疾病稳定以及疾病进展.符合正态分布的计量资料组间比较采用成组t检验,不符合正态分布的计量资料组间比较采用Wilcoxon秩和检验.计数资料两组间比较采用χ2检验.Kaplan-Meier法绘制生存曲线,Log-rank检验比较组间中位生存期(mOS)和中位无进展生存期(mPFS).采用单因素和多因素Cox比例风险模型分析影响患者预后的因素.结果 2组患者的Alb水平、肿瘤负荷情况比较,差异均有统计学意义(P值均<0.05).76例患者的mOS为25.2(95%CI:18.4～32.0)个月,mPFS为9.4(95%CI:7.1～11.7)个月,ORR为63.2%,DCR为82.9%.其中mALBI 1/2a组和2b组患者mOS分别为30.1(95%CI:19.8～40.4)个月和19.5(95%CI:7.1～31.9)个月,两组mOS差异有统计学意义(χ2=4.490,P=0.034).mALBI 1/2a组和 2b组患者mPFS分别为 10.2(95%CI:8.4～12.0)个月和 7.6(95%CI:4.6～10.6)个月,ORR分别为 71.1%和55.3%,DCR分别为86.8%和78.9%,mPFS、ORR和DCR比较,差异均无统计学意义(P值均>0.05).ECOG评分、肿瘤负荷、mALBI分级、门静脉侵犯和肝外转移是影响TACE联合靶免治疗患者mOS的独立危险因素(P值均<0.05).没有发生与治疗相关的死亡.结论 mALBI分级对预测TACE联合靶免治疗的Child-Pugh A级不可切除肝细胞癌患者的生存有较好的预测价值. 目的 研究改良白蛋白-胆红素分级 (mALBI分级) 对经导管动脉化疗栓塞术 (TACE) 联合免疫及抗血管生成药物治疗 (以下简称靶免治疗) 的Child-Pugh A级的不可切除肝细胞癌患者预后的评估价值。 方法 回顾性分析2020年1月—2023年1月在苏州大学附属第一医院和温州医科大学附属第五医院符合纳排标准的76例接受TACE联合靶免治疗的Child-Pugh A级不可切除肝细胞癌患者的资料，根据mALBI分级将其分为mALBI 1/2a组 (n=38) 和2b组 (n=38) 。主要研究终点为总生存期 (OS) ，次要研究结局为无进展生存期 (PFS) 、客观缓解率 (ORR) 、疾病控制率 (DCR) 。评估标准包括完全缓解、部分缓解、疾病稳定以及疾病进展。符合正态分布的计量资料组间比较采用成组t检验，不符合正态分布的计量资料组间比较采用Wilcoxon秩和检验。计数资料两组间比较采用χ2检验。Kaplan-Meier法绘制生存曲线，Log-rank检验比较组间中位生存期 (mOS) 和中位无进展生存期 (mPFS) 。采用单因素和多因素Cox比例风险模型分析影响患者预后的因素。 结果 2组患者的Alb水平、肿瘤负荷情况比较，差异均有统计学意义 (P值均<0.05) 。76例患者的mOS为25.2 (95%CI：18.4～32.0) 个月，mPFS为9.4 (95%CI：7.1～11.7) 个月，ORR为63.2%，DCR为82.9%。其中mALBI 1/2a组和2b组患者mOS分别为30.1 (95%CI：19.8～40.4) 个月和19.5 (95%CI：7.1～31.9) 个月，两组mOS差异有统计学意义 (χ2=4.490，P=0.034) 。mALBI 1/2a组和2b组患者mPFS分别为10.2 (95%CI：8.4～12.0) 个月和7.6 (95%CI：4.6～10.6) 个月，ORR分别为71.1%和55.3%，DCR分别为86.8%和78.9%，mPFS、ORR和DCR比较，差异均无统计学意义 (P值均>0.05) 。ECOG评分、肿瘤负荷、mALBI分级、门静脉侵犯和肝外转移是影响TACE联合靶免治疗患者mOS的独立危险因素 (P值均<0.05) 。没有发生与治疗相关的死亡。 结论 mALBI分级对预测TACE联合靶免治疗的Child-Pugh A级不可切除肝细胞癌患者的生存有 |
| Abstract_FL | Objective To investigate the ability of the modified albumin-bilirubin(mALBI)grade in predicting the prognosis of patients with Child-Pugh A unresectable hepatocellular carcinoma(uHCC)after transcatheter arterial chemoembolization(TACE)combined with immunotherapy and anti-angiogenic drugs(hereafter referred to as targeted immunotherapy).Methods A retrospective analysis was performed for the data of 76 patients with Child-Pugh A uHCC who met the inclusion criteria and underwent TACE combined with targeted immunotherapy in The First Affiliated Hospital of Soochow University from January 2020 to January 2023,and according to the mALBI grade,they were divided into mALBI 1/2a group with 38 patients and mALBI 2b group with 38 patients.The primary endpoint was overall survival(OS),and the secondary endpoints were progression-free survival(PFS),objective response rate(ORR),and disease control rate(DCR).Evaluation criteria included complete remission,partial remission,stable disease,and progressive disease.The independent-samples t test was used for comparison of normally distributed continuous data between groups,and the Wilcoxon rank-sum test was used for comparison of non-normally distributed continuous data between groups;the chi-square test was used for comparison of categorical variables between two groups.The Kaplan-Meier method was used to plot survival curves,and the Log-rank test was used for comparison of median OS(mOS)and median PFS(mPFS)between groups.The univariate and multivariate Cox proportional hazards models were used to analyze the influencing factors for prognosis.Results There were significant differences in albumin and tumor burden between the two groups(both P<0.05).The 76 patients had an mOS of 25.2 months(95%confidence interval[CI]:18.4-32.0),an mPFS of 9.4 months(95%CI:7.1-11.7),an ORR of 63.2%,and a DCR of 82.9%.The mOS was 30.1 months(95%CI:19.8-40.4)in the mALBI 1/2a group and 19.5 months(95%CI:7.1-31.9)in the mALBI 2b group,and there was a significant difference in mOS between the two groups(χ2=4.490,P=0.034).The mALBI 1/2a group had an mPFS of 10.2 months(95%CI:8.4-12.0),an ORR of 71.1%,and a DCR of 86.8%,while the mALBI 2b group had an mPFS of 7.6 months(95%CI:4.6-10.6),an ORR of 55.3%,and a DCR of 78.9%;there were no significant differences in mPFS,ORR,and DCR between the two groups(all P>0.05).ECOG status,tumor burden,mALBI grade,portal vein invasion,and extrahepatic metastasis were independent risk factors for mOS in patients undergoing TACE combined with targeted immunotherapy(all P<0.05).There were no treatment-related deaths.Conclusion The mALBI grade has a good value in predicting the survival of patients with Child-Pugh A uHCC undergoing TACE combined with targeted immunotherapy. |
| Author | 张申 徐啸阳 朱晓黎 李佳清 胡泽鑫 仲斌演 |
| AuthorAffiliation | 苏州大学附属第一医院介入科,江苏 苏州 215000 |
| AuthorAffiliation_xml | – name: 苏州大学附属第一医院介入科,江苏 苏州 215000 |
| Author_FL | ZHU Xiaoli HU Zexin LI Jiaqing ZHONG Binyan XU Xiaoyang ZHANG Shen |
| Author_FL_xml | – sequence: 1 fullname: LI Jiaqing – sequence: 2 fullname: XU Xiaoyang – sequence: 3 fullname: HU Zexin – sequence: 4 fullname: ZHANG Shen – sequence: 5 fullname: ZHONG Binyan – sequence: 6 fullname: ZHU Xiaoli |
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| Keywords | 化学栓塞,治疗性 Carcinoma,Hepatocellular mALBI Grade mALBI分级 Chemoembolization,Therapeutic 癌,肝细胞 |
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| PublicationTitle_FL | Journal of Clinical Hepatology |
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| Snippet | 目的 研究改良白蛋白-胆红素分级 (mALBI分级) 对经导管动脉化疗栓塞术 (TACE) 联合免疫及抗血管生成药物治疗 (以下简称靶免治疗) 的Child-Pugh A级的不可切除肝细胞癌患者预后的评估价值。 方法... 目的 研究改良白蛋白-胆红素分级(mALBI分级)对经导管动脉化疗栓塞术(TACE)联合免疫及抗血管生成药物治疗(以下简称靶免治疗)的Child-Pugh A级的不可切除肝细胞癌患者预后的评估价值.方法... |
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| SubjectTerms | Chemoembolization Immunotherapy Liver cancer Medical prognosis Remission (Medicine) |
| Title | 改良白蛋白-胆红素分级对经导管动脉化疗栓塞术联合免疫及抗血管生成药物治疗的Child-Pugh A级不可切除肝细胞癌患者预后的预测价值 |
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