| Objective:To explore the correlation between the decline range of AFP,the levels of C-reactive protein/albumin(CRP/Alb)ratio and the radiological evaluation on patients with hepatocellular carcinoma(HCC)after transcatheter arterial chemoembolization.Materials and methods :In this study,we pick up 86 patients diagnosed as HCC by The Second Hospital of Dalian Medical University's Comprehensive Treatment Center for Liver Cancer from 2016/5 to 2017/10.Overall patients who had undergone standardized TACE as the first treatment had been collected the pre-operative and 4 days after treatment blood samples,the imaging data of pre-operative and 30 days after treatment.Follow up regularly.Compared with the enhanced imaging data before and after the treatment,the effect of TACE was evaluated according to the Modified Response Evaluation Criteria In Solid Tumors(m-RECIST).Complete remission(CR)+ partial remission(PR)was defined as radiologic remission,stable disease(SD)+ disease progression(PD)was defined as radiologic un-remission.Analyzed and compared the correlation between each serological index and imaging remission,and predict the long-term prognosis of patients after TACE treatment.Results:1.Among the 86 cases,their serum levels of AFP and CRP before and after treatment were respectively: pre-operative was(749.64 ± 1318.75)IU / ml,(24.08 ± 26.08)?g / ml;on the fourth day after TACE treatment was(580.43 ± 1000.92)IU / ml,(87.76 ± 58.20)?g / ml.There was no significant correlation between serum CRP level and AFP level(Pearson correlation coefficient 0.114 P = 0.295).2.Overall cases come back to the hospital for a imageological examination in one month after treatment.Among them,57 patients were radiologic remission(CR+PR),and 29 patients were radiologic un-remission(SD+PD).The CRP,CRP/Alb and the decline range of AFP were made the receiver operating characteristic cure(ROC)with the radiologic remission.The result showed 4dsCRP,4dsCRP/Alb and AFP all have correlation with radiologic remission(AFP: ACU=0.85 4dsCRP/Alb: AUC=0.736 4dsCRP: AUC=0.708).The best cutoff level for 4dsCRP/Alb ratio was 3.58,sensitiveity was 78.9%,and specificity was 62.1%.3.All cases were divided into low 4dsCRP/Alb group and high 4dsCRP/Alb group with the best cutoff level of 3.58.Compared of clinical data between the two groups,patients' age,sex composition,Alt,pre-operative Alb and AFP level were not significantly different(P>0.05).In the high 4dsCRP/Alb group,the pre-operative CRP expression,the diameter of the tumor,the vascular invasion and the rough tumor around were more than low 4dsCRP / Alb group,the difference was statistically significant(P <0.05).4.Follow-up observed was total 18 months,with 29 patients have an end event.Kaplan-Meier curves showed a lower survival rate in patients with high 4dsCRP(48.3% vs26.3% P = 0.031),and have poor long-term survival after TACE.Conclusion:1.Before and after TACE treatment,the serum level of CRP / Alb ratio in HCC patients was not correlated with AFP,and also as the age,sex,pre-operative Alb.But was closely related to tumor diameter,liver function,vascular invasion and tumor margin.2.There were significant evaluation value of TACE treatment efficacy and prognosis by using 4dsCRP/Alb combined imaging examination of HCC patients.The sensitivity and specificity of 4dsCRP / Alb's evaluation value are lower than the AFP decline rate.But it can be used as a clinical supplement to evaluate the effect of treatment.3.The elevated postoperative CRP/Alb ratio indicates poor long-term prognosis of patients with HCC... |
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