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中国癌症防治杂志

中国癌症防治杂志 ›› 2026, Vol. 18 ›› Issue (1): 36-42.doi: 10.3969/j.issn.1674-5671.2026.01.05

• 论著 • 上一篇    下一篇

术后辅助性经导管动脉化疗栓塞术对细胞角蛋白19阳性肝细胞癌患者预后的影响：一项倾向性评分匹配队列研究

  

  1. 广西医科大学附属肿瘤医院肝胆胰脾外科；桂平市人民医院肿瘤科；广西医科大学附属肿瘤医院消化肿瘤内科
  • 出版日期:2026-02-25 发布日期:2026-03-26

Impact of postoperative adjuvant-transcatheter arterial chemoembolization on postoperative prognosis in cytokeratin 19-positive hepatocellular carcinoma patients: a propensity score matching cohort study

  • Online:2026-02-25 Published:2026-03-26

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摘要： 目的 探讨术后辅助性经导管动脉化疗栓塞术（postoperative adjuvant⁃transcatheter arterial chemoembolization，PA⁃TACE）在细胞角蛋白19（cytokeratin 19，CK19）阳性肝细胞癌（hepatocellular carcinoma，HCC）患者中的预后价值。方法　单中心回顾性队列研究纳入2013年1月至2018年12月在广西医科大学附属肿瘤医院接受根治性肝切除术且经病理证实为CK19阳性的HCC患者。根据术后是否接受PA⁃TACE将患者分为PA⁃TACE组（n=125）和Non⁃TACE（n=255）组， 1∶1倾向性评分匹配（propensity score matching，PSM）平衡两组患者，比较PSM前后无复发生存时间（relapse⁃free survival，RFS）与总生存时间（overall survival，OS）差异。结果 在380例患者中，PSM匹配前，PA⁃TACE组患者较Non⁃TACE组更年轻、乙型肝炎病毒感染率更高、多发肿瘤比例更高（均P<0.05）。整个队列中，PA⁃TACE组的中位RFS长于Non⁃TACE组（18.0个月 vs 8.0个月；HR=0.69,95%CI:0.52~0.91, P<0.001），中位OS亦显著改善（未达到 vs 39.0个月；HR=0.67,95%CI:0.49~0.92，P=0.013）。经过PSM后，对124对匹配患者的分析显示，PA⁃TACE组的中位RFS（17.0个月 vs 7.0个月；HR=0.69，95%CI：0.50~0.95，P<0.001）和中位OS（未达到 vs 41.0个月；HR=0.69，95%CI：0.48~0.99, P=0.044）仍优于Non⁃TACE组。结论 在这项针对CK19阳性HCC患者的回顾性队列研究中，肝切除术后接受PA⁃TACE与更长的RFS和OS相关。PA⁃TACE可能是该人群的一种有益辅助治疗策略。

关键词: 肝细胞癌, 细胞角蛋白19, 肝切除术, 术后辅助性经导管动脉化疗栓塞术

Abstract: Objective To investigate the prognostic value of postoperative adjuvant⁃transcatheter arterial chemoembolization (PA⁃TACE) in patients with cytokeratin 19 (CK19)⁃positive hepatocellular carcinoma (HCC). Methods This single⁃center retrospective cohort analysis enrolled patients with pathologically confirmed CK19⁃positive HCC who underwent radical hepatectomy at Guangxi Medical University Cancer Hospital from January 2013 to December 2018. Participants were stratified into the PA⁃TACE group (n=125) and Non⁃TACE group (n=255) based on postoperative receipt of PA⁃TACE. A 1∶1 propensity score matching (PSM) procedure was performed between the two groups, and differences in relapse⁃free survival (RFS) and overall survival (OS) were compared between the two groups pre⁃ and post⁃PSM. Results In a cohort of 380 patients, pre⁃PSM analysis showed that the PA⁃TACE group was younger, exhibited a higher rate of hepatitis B virus infection, and a higher proportion of multiple tumors compared with the Non⁃TACE group (all P<0.05). Across entire cohort, the median RFS in the PA⁃TACE group was significantly longer than that in the Non⁃TACE group (18.0 months vs 8.0 months; HR=0.69, 95%CI: 0.52-0.91， P<0.001), and the median OS was also significantly improved (not reached vs 39.0 months; HR=0.67, 95%CI: 0.49-0.92， P=0.013). Following  PSM, 124 matched patient pairs were obtained, and the PA⁃TACE group still had superior median RFS (17.0 months vs 7.0 months; HR=0.69,95%CI: 0.50-0.95， P<0.001) and median OS (not reached vs 41.0 months; HR=0.69, 95%CI: 0.48-0.99， P=0.044) compared with the Non⁃TACE group. Conclusions In this retrospective cohort study of patients CK19⁃positive HCC, postoperative PA⁃TACE was associated with prolonged RFS and OS. These findings suggest that PA⁃TACE may serve as a beneficial adjuvant therapeutic strategy for this population.

Key words: Hepatocellular carcinoma, Cytokeratin 19, Hepatectomy, Postoperative adjuvant?transcatheter arterial chemoembolization

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