IMAGING SCIENCE AND PHOTOCHEMISTRY ›› 2023, Vol. 41 ›› Issue (6): 320-325.DOI: 10.7517/issn.1674-0475.230712

• Review and Articles • Previous Articles     Next Articles

Preoperative Imaging Score Combined with Tumor Marker to Evaluate the Prognosis of Hepatocellular Carcinoma after TACE

XIA Zhiying, DU Fuchuan   

  1. Department of Radiology, Hainan Traditional Chinese Medicine Hospital, Haikou 570203, Hainan, P. R. China
  • Received:2023-07-24 Online:2023-11-23 Published:2023-12-14

Abstract: To evaluate the value of imaging tumor burden score (TBS) combined with serum alpha-fetoprotein (AFP) in the prognosis of hepatocellular carcinoma (HCC) after transarterial chemo-embolization (TACE). Clinical and imaging data of 87 HCC patients who underwent TACE were collected. The TBS scores were calculated from CT-enhanced images. OS was compared between groups using Kaplan-Meier survival curves and log-rank test. The median survival of HCC patients after TACE was 20.5 months, and the mean TBS score was 9.52±3.26. The results showed that the 3-year OS decreased progressively with increasing TBS (P<0.001); the difference in OS between patients with TBS ≤ 9.9 and TBS>9.9 was statistically significant (P<0.001). Patients' pre-TACE AFP levels were moderately negatively correlated with OS (r=-0.519; P<0.001), and OS was worse in patients with AFP ≥ 400 ng/mL compared with those with AFP < 400 ng/mL (P=0.001). Multifactorial analysis showed that patients with TBS ≤ 9.9 and AFP ≥ 400 ng/mL (HR:5.449; 95%CI:1.951-15.217; P=0.01), TBS>9.9 and AFP<400 ng/mL (HR:13.576; 95%CI:5.873-31.382; P<0.001) and TBS>9.9 and AFP ≥ 400 ng/mL (HR:27.854; 95%CI:8.950-86.683; P<0.001) were both independent predictors of OS after TACE in patients with hepatocellular carcinoma, and the OS of patients with TBS ≤ 9.9 and AFP<400 ng/mL was better than the other three groups (P<0.05). Therefore, the image-based TBS score combined with AFP level has a high value in the prognosis assessment of HCC patients with TACE.

Key words: hepatocellular carcinoma, transarterial chemo-embolization, tumor burden score, alpha-fetoprotein