purpose: to evaluate whether afp classification criteria correlate with tumor response measured using the european association for the study of the liver (easl) and predicate survival in patients with hepatocellular carcinoma (hcc) after transarterial chemoembolization (tace).
methods: data from 143 consecutive patients with unresectable hcc and elevated afp (>20 ng/ml), who underwent tace as initial treatment between january 2011 and december 2015 were collected, retrospectively. afp response was classified as follows: complete response, normalization of afp; partial response, >50% decrease from baseline; stable disease, -50 to 30% change from baseline; or progressive disease, >30% increase from baseline. response rates according to afp and easl criteria were compared, and associations between the afp response and overall survival (os) were evaluated.
方法：回顾性收集2011年1月至2015年12月间行tace进行初始治疗的143例不可切除hcc且afp升高(> 20 ng/ml)患者的资料。afp应答分为完全缓解、afp正常化；部分缓解，较基线下降>50%；病情稳定，较基线变化- 50- 30%；或进展性疾病，较基线增加>30%。对以afp和easl标准为依据的应答率进行比较，并评估afp应答与总生存(os)之间的相关性。
results: the k value for agreement between afp criteria and easl criteria was 0.52 (moderate), with response rates of 42.7% and 41.3%, respectively (p = 0.811). the os of responders was significantly longer compared with non-responders for both afp (21 vs. 6 months, p<0.001) and easl (23 vs. 6 months, p<0.001). multivariate analysis revealed that the afp response (hazard ratio [hr], 0.430, 95% ci, 0.233-0.794; p=0.007), easl response (hr, 0.343; 95% ci, 0.176-0.666; p=0.002), and macroscopic vascular invasion (hr, 2.104; 95% ci, 1.403-3.154; p<0.001) were significantly associated with os.
结果：afp标准与easl标准一致的k值为0.52(中等)，缓解率分别为42.7%和41.3% (p = 0.811)。无论是参照afp(21个月vs. 6个月，p < 0.001)还是easl(23个月vs. 6个月，p < 0.001)，有应答者的os明显长于无应答者。多因素分析显示，afp应答(hr, 0.430, 95% ci, 0.233-0.794; p = 0.007)、easl应答(hr, 0.343; 95% ci, 0.176-0.666; p=0.002)以及肉眼可见的血管侵犯(hr, 2.104; 95% ci, 1.403-3.154; p<0.001)与os显著相关。
conclusions: the defined afp classification criteria was moderate correlated with easl criteria and predicted the outcome in patients with hcc who underwent tace.