血清淀粉样蛋白A对TACE联合靶向及免疫治疗的中晚期肝细胞癌患者预后的预测价值OA

Objective To explore the predictive value of serum amyloid A(SAA)levels for the prognosis of patients with advanced hepatocellular carcinoma(HCC)who received transcatheter arterial chemoembolization(TACE)combined with targeted therapy and immunotherapy.Methods A total of 78 patients with advanced HCC who received TACE combined with targeted drugs and immune checkpoint inhibitors as first-line treatment at the First Affiliated Hospital of Zhejiang Chinese Medical University(n=21)and Zhejiang Cancer Hospital(n=57)from January 2020 to December 2023 were selected retrospectively.The optimal cutoff value of SAA for predicting objective tumor response was determined using receiver operating characteristic(ROC)curve analysis,and patients were accordingly stratified into low-and high-level SAA groups.Follow-up was conducted until September 30,2025.Prognostic outcomes were compared between the two groups,and univariate and multivariate Cox regression models were employed to identify factors influencing patient prognosis.Results Survival analysis demonstrated that the 39 patients in the low-level SAA group(SAA＜19.5 mg/L)had significantly prolonged median progression-free survival(15.3 months vs.9.0 months,P＜0.05)and median overall survival(33.8 months vs.19.4 months,P＜0.05)compared with the 39 patients in the high-level SAA group(SAA ≥19.5 mg/L).The objective response rate was significantly higher in the low-level SAA group than in the high-level SAA group(59.0％vs.15.4％,P＜0.05).High SAA level was identified as an independent risk factor for prognosis in patients with intermediate-advanced HCC(P＜0.05).Conclusion SAA level has a good predictive value for the prognosis of advanced HCC patients treated with TACE combined with targeted and immunotherapy,and an SAA level ≥19.5 mg/L serves as an independent adverse prognostic factor.