ỨNG DỤNG TIÊU CHUẨN KINKI TRONG PHÂN CHIA DƯỚI NHÓM UNG THƯ BIỂU MÔ TẾ BÀO GAN GIAI ĐOẠN TRUNG GIAN=Kinki criteria for the subclassification of intermediate-stage hepatocellular carcinoma: Clinical implication

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Tác giả: Trọng Bỉnh Lê, Anh Tuấn Nguyễn, Thị Thu Huyền Nguyễn

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Điện quang và Y học hạt nhân Việt Nam, 2024

Mô tả vật lý: tr.41-47

Bộ sưu tập: Metadata

ID: 486868

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Mục tiêu: Ứng dụng tiêu chuẩn Kinki trong phân giai đoạn ung thư biểu mô tế bào gan (UTBMTBG) giai đoạn trung gian.Đối tượng và phương pháp nghiên cứu: 109 bệnh nhân UTBMTBG giai đoạn trung gian tại Bệnh viện trường Đại học Y-Dược Huế và Bệnh viện Trung ương Huế từ 01/2022 đến 08/2023. Chẩn đoán UTBMTBG theo hướng dẫn của Bộ Y tế 2020. Phân giai đoạn trung gian theo BCLC 2012. Phân loại dưới nhóm UTBMTBG giai đoạn trung gian theo tiêu chuẩn Kinki. Đối chiếu chỉ định điều trị trên lâm sàng và theo khuyến cáo của BCLC và tiêu chuẩn Kinki.Kết quả: Tuổi trung bình: 64,2 ± 13 tuổi, nam/nữ: 7/1. Kích thước u trung bình: 8,9 ± 3,6 cm. Phân dưới nhóm 109 bệnh nhân UTBMTBG giai đoạn trung gian (BCLC-B) theo tiêu chuẩn Kinki như sau: B1 n=21 (19,3%), B2 n=76 (69,7%), B3 n=12 (11%) trong đó B3a n=2 (1,8%), B3b n=10 (9,2%). Chỉ định điều trị trên thực tế lâm sàng bao gồm TACE (47,7%), phẫu thuật (22%), hóa trị (18,3%), nội khoa (9,2%), RFA (2,8%). Có 52,3% chỉ định điều trị nằm ngoài khuyến cáo BCLC 2012. Đối chiếu chỉ định điều trị trên lâm sàng và khuyến cáo của tiêu chuẩn Kinki nhận thấy: 100% bệnh nhân dưới nhóm B1
76,4% bệnh nhân dưới nhóm B2 và 66,7% bệnh nhân dưới nhóm B3 có chỉ định điều trị trên thực tế tương ứng với khuyến cáo điều trị theo tiêu chuẩn Kinki.Kết luận: UTBMTBG giai đoạn trung gian không đồng nhất về các đặc điểm hình ảnh và chức năng gan. Chỉ định điều trị UTBMTBG trên thực tế không hoàn toàn giống với khuyến cáo của BCLC 2012. Cần phân loại chi tiết bệnh nhân UTBMTBG giai đoạn trung gian theo tiêu chuẩn Kinki để tối ưu hoá chiến lược điều trị và cải thiện tiên lượng.Purpose: to subclassify the intermediate stage hepatocellular carcinoma (HCC) by using Kinki criteria.Methods: A cross-sectional study was conducted on 109 patients with intermediate stage HCC from 01/2022 to 08/2023 at Hue University of Medicine and Pharmacy Hospital and Hue Center Hospital. HCC was diagnosed using the practice guideline of the Ministry of Health 2020, classified into the intermediate stage according to BCLC 2012. Intermediate stage HCC was then subclassified by using Kinki criteria. Treatment indications were documented. Clinical implication of Kinki criteria was reviewed and discussed.Results: Mean age: 64.2 ± 13 years, male: female ratio 7:1. Average tumor size: 8.9 ± 3.6 cm. Subclassification of 109 intermediate stage HCC (BCLC-B) included 21 (19.3%) B1, 76 (69.7%) B2, and 12 (11%) B3. The subgroup B3 was further classified as B3a (n=2, 1.8%) and B3b (n=10, 9.2%). Treatment indications followed BCLC-B 2012 recommendation in 47.7% of cases (TACE: transarterial chemoembolization) whereas 52.3% were outside, including resection (22%), systemic chemotherapy (18.3%), conservative (9.2%) and radiofrequency ablation (2.8%). Comparing clinical treatment indications and recommendations of Kinki criteria we found: 100% of patients were in group B1
76.4% of patients in group B2 and 66.7% of patients in group B3 received treatment corresponding to therecommendation of Kinki criteria.Conclusion: Intermediate-stage HCC encompasses a wide and heterogeneous population in terms of performance status, tumor burden and underlying liver function. Subclassification of patients in this stage using Kinki criteria helps optimize treatment strategies and improve patient prognosis.

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