Child-Pugh grade deterioration stratified by the etiology after transcatheter arterial chemoembolization as initial treatment for hepatocellular carcinoma
Child-Pugh grade deterioration stratified by the etiology after transcatheter arterial chemoembolization as initial treatment for hepatocellular carcinoma
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DOI：
10.1038/s41598-024-53709-6
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发表时间：
2024-02-14
影响因子：
4.6
通讯作者：
Kooka，Yohei
中科院分区：
文献类型：
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作者：
Yoshitomi，Kengo;Hayashi，Tsuguru;Kooka，Yohei
经导管动脉化疗栓塞（TACE）是中期肝细胞癌（HCC）的标准治疗方法。然而，TACE会导致肝功能恶化。我们的目的是确定影响TACE术后肝功能恶化的因素。我们回顾性分析了262例接受TACE作为Child-Pugh a级HCC初始治疗的患者。我们根据潜在肝脏疾病的病因将他们分为三组。患者分为乙型肝炎病毒（HBV）组、丙型肝炎病毒（HCV）组和非HBV /非HCV （NBNC）组。比较三组患者术后1个月肝功能及Child-Pugh分级为B级或C级的时间。HBV、HCV和NBNC组分别有23例、123例和116例患者。NBNC组TACE术后白蛋白水平下降明显高于其他组（p = 0.02）。NBNC组Child-Pugh级恶化时间较HBV组和HCV组短（p < 0.001）。多因素Cox回归分析显示，NBNC组是Child-Pugh分级恶化的显著因素（风险比3.74,95%可信区间1.89 ~ 7.40,p < 0.001）。结果显示，TACE术后肝功能恶化以NBNC组最为明显。
Transcatheter arterial chemoembolization (TACE) is a standard treatment for intermediate-stage hepatocellular carcinoma (HCC). However, TACE can cause deterioration of liver functions. We aimed to identify the factors that influence deterioration of liver function after TACE. We retrospectively analyzed 262 patients who underwent TACE as initial treatment for HCC with Child–Pugh grade A. We divided them into three groups stratified by the etiology of underlying liver disease. Patients were classified into hepatitis B virus (HBV) group, hepatitis C virus (HCV) group, and non-HBV / non-HCV (NBNC) group. Liver functions at one month after TACE and time to Child–Pugh grade B or C were compared between the three groups. The HBV, HCV and NBNC groups contained 23, 123 and 116 patients, respectively. The decline in albumin level after TACE was significantly higher in NBNC group than other groups (p = 0.02). NBNC group showed a shorter time to Child–Pugh grade deterioration compared with HBV group and HCV group (p < 0.001). Multivariate Cox regression analysis showed that NBNC group was a significant factor for Child–Pugh grade deterioration (Hazard ratio 3.74, 95% confidence interval 1.89–7.40, p < 0.001). These results revealed that liver functions worsened most remarkably in NBNC group after TACE.