Correlation analysis of preoperative serum alpha-fetoprotein (AFP) level and prognosis of hepatocellular carcinoma (HCC) after hepatectomy.
Correlation analysis of preoperative serum alpha-fetoprotein (AFP) level and prognosis of hepatocellular carcinoma (HCC) after hepatectomy.
复制标题
肝细胞癌(HCC)肝切除术后术前血清甲胎蛋白(AFP)水平与预后的相关性分析
DOI：
10.1186/1477-7819-11-212
复制
发表时间：
2013-08-27
影响因子：
3.2
通讯作者：
Teng LS
中科院分区：
文献类型：
--
作者：
Ma WJ;Wang HY;Teng LS
目的通过比较肝癌患者术前血清甲胎蛋白（AFP）水平与术后病理特征、复发率及生存率的关系，探讨AFP水平对肝癌预后的预测价值。选取2005年至2011年在我院行肝切除术的肝癌患者108例。根据术前血清AFP水平将患者分为AFP ≤ 20 ng/mL组、AFP 20 ~ 400 ng/mL组和AFP > 400 ng/mL组，比较其临床病理和细胞病理学特征。所有患者均随访24个月，比较分析术后复发率和生存率，并对影响肝癌术后生存率的危险因素进行多因素回归分析。108例肝癌患者中，AFP ≤20 ng/mL组42例，AFP 20-400 ng/mL组28例，AFP > 400 ng/mL组39例。结果显示：3组间细胞分化程度（χ2 = 20.198，P = 0.000）和微血管浸润率（χ2 = 20.358，P = 0.000）差异有统计学意义。AFP ≤ 20 ng/mL组细胞分化程度高于其他各组，微血管浸润率低于其他各组（P < 0.05）。随访资料显示，术后2年复发率（χ2 = 6.164，P = 0.046），18个月生存率（χ2 = 7.647，P = 0.022）和24个月生存率（χ2 = 6.725，P = 0.035）有显著性差异，AFP ≤ 20 ng/mL组术后2年复发率较低，18个月生存率和24个月生存率明显高于其他两组（P <0.05）。多因素Logistic回归分析显示，肿瘤直径（≥ 5cm）、术前血清AFP水平（> 400 ng/mL）与肝癌术后生存率密切相关（P <0.05）。提示术前血清AFP水平对肝癌的恶性程度及预后有一定的预测价值。提示无手术禁忌证、血清AFP ≤ 20 ng/mL的肝癌患者行一期肝切除术获益最大。血清AFP> 20 ng/mL的肝癌患者除手术切除和密切随访外，还需综合治疗。
To investigate the prediction value of preoperative serum alpha-fetoprotein (AFP) level for the prognosis of hepatocellular carcinoma (HCC), by comparing pathological characteristics, recurrence rate and survival rate after hepatectomy. 108 cases of HCC patients who received liver resection in our hospital from 2005 to 2011 were enrolled in this study. According to preoperative serum AFP level, the patients were divided into AFP ≤ 20 ng/mL group, AFP 20 to 400 ng/mL group and AFP > 400 ng/mL group, and the clinicopathological and cytopathological features were compared. All the patients were followed up for 24 months, the postoperative recurrence rates and survival rates were compared and analyzed, and the risk factors for HCC postoperative survival rate were studied by multifactor regression analysis. Of the 108 cases of HCC patients, there were 42 cases in AFP ≤20 ng/mL group, 28 cases in AFP 20–400 ng/mL group and 39 cases in AFP > 400 ng/mL group. It was shown that cell differentiation degrees (χ2 = 20.198, P = 0.000) and microvascular invasion rates (χ2 = 20.358, P = 0.000) were significantly different among the three groups. The AFP ≤ 20 ng/mL group showed higher cell differentiation degrees and significantly lower microvascular invasion rates compared to the other groups (P < 0.05). The follow-up data showed that postoperative 2-year recurrence rate (χ2 = 6.164, P = 0.046), 18-month survival rate (χ2 = 7.647, P = 0.022) and 24-month survival rate (χ2 = 6.725, P = 0.035) of the three groups were significantly different, and we found that the AFP ≤ 20 ng/mL group had lower postoperative 2-year recurrence rate, and higher 18-month survival rate and 24-month survival rate than the other two groups (P <0.05). Multiple logistic regression analysis indicated that tumor diameter (≥ 5 cm) and preoperative serum AFP level (> 400 ng/mL) were closely correlated with HCC postoperative survival rate (P <0.05). It is shown that preoperative serum AFP level has considerable predictive value for the malignant feature and prognosis of HCC. It is suggested that HCC patients with no contraindication of operation and serum AFP ≤ 20 ng/mL can benefit most from primary treatment of hepatectomy. While HCC patients with serum AFP higher than 20 ng/mL need comprehensive therapy besides surgical resection and close follow up.
登录
查看更多内容
影响因子：
3.2
作者：
Reichman, TCW;Bahyramipour, P;Harrison, LE
通讯作者：
Harrison, LE
影响因子：
2.3
作者：
Ha, Nghi B.;Ha, Nghiem B.;Nguyen, Mindie H.
通讯作者：
Nguyen, Mindie H.
DOI：
10.1046/j.1440-1746.1999.01873.x
发表时间：
1999-05-01
影响因子：
4.1
作者：
Johnson, PJ
通讯作者：
Johnson, PJ
影响因子：
3.1
作者：
Tong, Myron John;Hsien, Carlos;Blatt, Lawrence Mitchell
通讯作者：
Blatt, Lawrence Mitchell
DOI：
10.1016/j.jamcollsurg.2010.01.007
发表时间：
2010-05-01
影响因子：
5.2
作者：
Levi, David M.;Tzakis, Andreas G.;Livingstone, Alan S.
通讯作者：
Livingstone, Alan S.