实用肿瘤杂志2025，Vol.40Issue(3)：238-245,8.DOI:10.13267/j.cnki.syzlzz.2025.036
淋巴细胞计数和丙氨酸氨基转移酶评估肝细胞癌经肝动脉插管化疗栓塞术联合免疫治疗的预后的价值
Prognostic value of lymphocyte count and alanine aminotransferase in hepatocellular carcinoma treated with transcatheter arterial chemoembolization and immunotherapy
摘要
Abstract
Objective To analyze the value of lymphocyte count(LC)and alanine aminotransferase(ALT)in predicting the prognosis of intermediate to advanced hepatocellular carcinoma(HCC)patients after transcatheter arterial chemoembolization(TACE)combined with immunotherapy.Methods The clinical data of 32 patients with intermediate to advanced primary HCC who received TACE combined with programmed death-1(PD-1)/programmed death-ligand 1(PD-L1)immune checkpoint inhibitors at Tianjin Second People's Hospital from January 2021 to November 2023 were retrospectively analyzed.The patients were divided into progression group and non-progression group according to the status of disease progression within 6 months after treatment retrieved from electronic medical records or telephone follow-up.Serological indicator levels within 14 days before treatment and within 2 months after treatment were compared between the two groups.Receiver operating characteristic(ROC)curves were used to analyze the prognostic performance of LC,ALT level,and their combination.Cox regression model was used to identify independent risk factors affecting the progression free survival(PFS)of intermedi-ate to advanced HCC patients.Results According to the ROC curves,the optimal cut-off points of LC and ALT level were 0.740×109/L and 32.30 U/L before treatment,and 0.805×109/L and 22.95 U/L after treatment.Univariate Cox regression analysis showed that LC,ALT level,aspartate transferase(AST)level,and liver fibrosis-4 index before treatment were the influencing factors for the PFS of intermedi-ate to advanced HCC patients treated with TACE combined with immunotherapy(all P<0.05),while multivariate Cox regression analysis showed that LC≤0.740×109/L(HR=3.896,95%CI:1.244-12.201)and ALT>32.30 U/L(HR=1.015,95%CI:1.000～1.029)were the independent risk factors(both P<0.05).Kaplan-Meier survival analysis showed that patients with high pre-and post-treatment peripheral blood LC,and low ALT level had longer PFS.Conclusions LC and ALT level before treatment,along with the subsequent changes in LC,are clinically important for assessing the efficacy and prognosis of TACE combined with immunotherapy in treating intermediate to ad-vanced HCC patients.关键词
中晚期肝细胞癌/淋巴细胞/丙氨酸氨基转移酶/预后Key words
intermediate to advanced hepatocellular carcinoma/lymphocyte/alanine aminotransferase/prognosis引用本文复制引用
霍志晓,闫莉华,乔坤艳,蒯文涛,李娜,苏瑞..淋巴细胞计数和丙氨酸氨基转移酶评估肝细胞癌经肝动脉插管化疗栓塞术联合免疫治疗的预后的价值[J].实用肿瘤杂志,2025,40(3):238-245,8.基金项目
天津市医学重点学科(专科)建设项目(TJYXZDXK-059B) （专科）
天津市卫生和计划生育委员会中西医结合科研课题重点项目(2021022) （2021022）
天津市卫生健康科技项目重点学科专项(TJWJ2022XK034) （TJWJ2022XK034）
