目的：探讨原发性肝癌（ HCC）患者经肝动脉化疗栓塞（ TACE）治疗后，血清γ-谷氨酰转肽酶（ GGT）对判断预后的价值。方法总共有150例中期HCC患者连续用肝动脉栓塞化疗。总生存（ OS）用Kaplan-Meier法进行了评估。根据治疗前GGT值，Log-rank对数秩方法评估显著差异。单变量和多变量分析用于预后因素的研究。结果中位随访期为18．7个月。正常GGT的患者1年和3年生存率分别为71．6％和38．5％，高GGT患者1年和3年生存率分别8．8％和16．9％（ P＝0．002）。高GGT患者的肿瘤偏大，甲胎蛋白（ AFP）和丙氨酸转氨酶水平偏高，高GGT是患者OS的独立预后因素之一（P＝0．009），其他预后因素包括肿瘤大小和腹腔积液。此外，在小肝癌和正常AFP亚组的血清GGT也与患者OS相关（P＝0．013和0．041）。结论 GGT水平是预测肝癌患者肝动脉栓塞化疗治疗预后的一个重要因素。GGT和AFP的联合能更好预测TACE的治疗效果。%Objective To investigate the predictive value of serum γ-glutamyl peptidase ( GGT) for the prognosis of hepatocellular carcinoma ( HCC) after hepatic arterial chemoembolization ( TACE) .Methods 150 cases of the middle HCC pa-tients received TACE.Overall survival ( OS) were evaluated by Kaplan-Meier method.According to pretreatment GGT value,sig-nificant differences were evaluated by log rank method.Univariate and multivariate analysis was used in the study of prognostic factors.Results The median follow-up period was 18.7 months.1-and 3-year survival rates of patients with normal GGT were 71.6%and 38.5%,and those with high GGT were 8.8%and 16.9%(P=0.002).Patients with high GGT had large tumors, high alpha-fetoprotein ( AFP) and alanine aminotransferase levels,high GGT was an independent prognostic factor of OS ( P=0.009) ,other prognostic factors included tumor size and ascites.In addition,serum GGT in small hepatocellular carcinoma and normal AFP subgroups was associated with OS (P=0.013 and 0.041).Conclusion GGT level has important predictive value for the prognosis of HCC after TACE.Combined detection of AFP and GGT has better predictive value for efficacy of TACE.
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