| Objective:To collect imaging and serological data of patients with hepatitis B virus(HBV)-associated hepatocellular carcinoma(HCC)before and after the first TACE treatment,to analyze the correlation between serum lipids and alpha-fetal protein(AFP)before TACE treatment,and to study the change pattern of serum lipids before and after TACE treatment and its application value in the evaluation of TACE efficacy.The correlation between serum lipids and alpha-fetoprotein(AFP)before TACE treatment was analyzed,and the change pattern of serum lipids before and after TACE treatment and its application value in the evaluation of TACE efficacy were studied.Methods:Fifty-nine patients who received TACE for the first time for hepatitis B-associated hepatocellular carcinoma(HBV-HCC)at the Interventional Department of Qing hai University Hospital from May 2017 to January 2019 and met the inclusion and exclusion criteria were selected for retrospective analysis,and serum liver function,lipids,AFP,and AFP were collected and collated from all patients at the end of pre-TACE,1 week and 4-6 weeks after TACE.Hepatitis B virus Deoxyribonucleic acid(HBV-DNA)quantification,maximum tumor diameter,number of tumors,portal vein invasion,Child-Pugh classification,CT and MRI findings,and other clinical data were collected and analyzed,and the basic information of all patients [gender,age,height,Body Mass Index(BMI)].The effect of TACE treatment was evaluated according to the modified efficacy evaluation criteria for solid tumor treatment(m-RECIST),and patients with complete remission(CR)+ partial remission(PR)were classified as remission group,and patients with stable disease(SD)+ disease progression(PD)were classified as unremitting group.SPSS24.0 software was selected for statistical analysis of the data collected.The correlation of serum lipids and AFP in the two groups before and after TACE treatment were analyzed to find out the valuable indicators for assessing the treatment effect.Results:1.31 patients in the remission group and 28 patients in the non-remission group were included in the study,and there was no statistically significant difference in the comparative analysis of general and serological data between the two groups before TACE treatment(P > 0.05).2.Before TACE,serum Apo A1,TG,HDL-C,TC,LDL-C,and AFP were not significantly different in all 59 patients.Apo B and AFP were not significantly correlated(P > 0.05).3.Intra-group comparison: in the remission group,at 1 week postoperatively,patients’ serum TC,TG,HDL-C,LDL-C,Apo A1,Apo B and AFP were significantly lower than those before surgery(P < 0.05).At 4-6 weeks postoperatively,serum AFP was significantly lower than preoperatively(P < 0.05),serum TC was significantly higher than preoperatively(P < 0.05),and other serum lipid indices were not significantly different compared to preoperative(P > 0.05);in the unremitting group,at 1 week postoperatively,patients with serum AFP,Apo A1,TC,HDL-C,Apo B and LDL-C were significantly lower than those before surgery(P < 0.05),and serum TG was not significantly different from that before surgery(P > 0.05).At 4-6 weeks postoperatively,serum TC was significantly lower than that before surgery(P < 0.05),serum TG was importantly taller than that before surgery(P < 0.05),and serum Apo B,LDL-C,Apo A1,HDL-C and AFP were not significantly different from those before surgery(P > 0.05).Comparison between groups: At 4-6 weeks postoperatively,serum TC and Apo A1 were importantly higher in the relieved group than in the not relieved group(P < 0.05),serum TG and AFP were importantly lower than in the not relieved group(P < 0.05),and serum LDL-C,HDL-C,and Apo B were not importantly different from those in the not relieved group(P > 0.05).4.Serum TC,TG,HDL-C,LDL,and AFP were significantly different between the two groups at 4-6 weeks postoperatively(P > 0.05).The percentages of serum HDL-C,TC,Apo A1,TG,LDL-C,Apo B and AFP levels in the two groups at4-6 weeks after surgery were compared with those before surgery.ROC curve analysis was performed,and the diagnostic value of the combined test was better than that of the individual tests,and the diagnostic value was greatest for AFP%+TC%when the area under the curve(AUC)was 0.875,0.674,0.942,0.974,and 0.955 for TC%,Apo A1%,AFP%,AFP%+TC%,and AFP%+Apo A1%,respectively.Conclusion:.1.preoperative serum TC,TG,HDL-C,LDL-C,Apo A1 and Apo B levels of HBV-HCC patients were not significantly correlated with AFP.2.After HBV-HCC patients were treated with TACE,serum TC,TG,HDL-C,LDL-C,Apo A1 and Apo B levels showed a trend of first decreasing and then increasing,but the magnitude of each index varied in different groups of patients,and postoperative testing of serum TC,TG and Apo A1 helped to initially determine the treatment effect,and low levels of TC,Apo A1 and Apo A1 were associated with the treatment effect.Apo A1 and high levels of TG were associated with poor postoperative lesion control in patients.3.Combined detection of serum AFP,TC,and Apo A1 before and after TACE treatment in HBV-HCC patients can better assess the efficacy. |
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