中国实用外科杂志

中国实用外科杂志

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血清维生素D对晚期肝内胆管癌病人预后及化疗敏感度预测价值研究

孙大鹏，袁声贤，张家宁，李    雯，丁文斌，周伟平   

  1. 海军军医大学第三附属医院肝外三科，上海200438
  • 出版日期:2021-03-01 发布日期:2021-03-18

  • Online:2021-03-01 Published:2021-03-18

摘要： 目的    评估血清维生素D水平对无法进行手术的晚期肝内胆管癌病人的预后和化疗敏感度的预测价值。方法    回顾性分析海军军医大学第三附属医院收治的41例无法手术的晚期肝内胆管癌病人的临床资料，按照实体瘤评价标准（RECIST 1.1版）对病人化疗情况进行分析。采用受试者工作特征曲线（ROC），单因素及多因素分析以及生存曲线明确血清维生素D水平对肝内胆管癌病人化疗敏感度及预后的预测价值。结果    肝内胆管癌病人的血清维生素D水平低于健康人群（P＜0.0001）。与维生素D低表达组相比，高表达组有更高比例的病人达到“部分缓解”和“病变稳定”（P=0.013），其疾病缓解率（DCR）和客观缓解率（ORR）分别为66.7%和22.2%；而低表达组相应数据分别为26.1%和8.7%。高表达组的无进展生存率和总体生存率均比低表达组更高（P=0.022 vs. P=0.007），差异有统计学意义。结论    血清维生素D水平对无法手术的晚期肝内胆管癌病人的化疗敏感度及预后有一定的预测价值。

关键词: 维生素D, 化疗敏感性, 预后, 肝内胆管癌

Abstract: Predictive value of serum vitamin D for chemosensitivity and prognosis of unresectable advanced intrahepatic cholangiocarcinoma patients        SUN Da-peng, YUAN Sheng-xian, ZHANG Jia-ning, et al. The Third Department of Hepatic Surgery, the Third Affiliated Hospital of Naval Medical University, Shanghai 200438, China
Corresponding author：ZHOU Wei-ping, E-mail:ehphwp@126.com
Abstract    Objective    To evaluate predictive significance of the serum vitamin D level for patients’ prognosis and their chemosensitivity in unresectable advanced intrahepatic cholangiocarcinoma （iCCA） patients. Methods    The clinical data of 41 unresectable advanced iCCA patients who received chemotherapies in the Third Affiliated Hospital of Naval Medical University were collected and analyzed retrospectively. Patients’ chemotherapy responses were evaluated by RECIST 1.1 version. Receiver operating characteristic（ROC）curves，univariate and multivariate analysis as well as Kaplan-Meier curves were applied to verify the predictive significance of serum vitamin D level for chemosensitivity and prognosis of iCCA patients. Results    The serum level of vitamin D was lower in iCCA patients than healthy controls（P＜0.0001）. A higher proportion of patients achieved PR and SD in the higher expression subgroup than those in the low-expression subgroup（P=0.013）. The disease control rate（DCR）and objective response rate（ORR）of high-expression group were 66.7% and 22.2%，respectively. While in the low expression group，the corresponding DCR and ORR were 26.1% and 8.7%. The progression-free survival and overall survival rates of high expression group were significantly higher than those with low vitamin D expression in iCCA patients（P=0.022 vs. P=0.007，respectively）. Conclusion Serum vitamin D levels denotes the chemosensitivity and has a predictive value for prognosis of unresectable advanced iCCA patients.

Key words: vitamin D, chemosensitivity, prognosis, intrahepatic cholangiocarcinoma