The prognostic correlation of AFP level at diagnosis with pathological grade, progression, and survival of patients with hepatocellular carcinoma.
The prognostic correlation of AFP level at diagnosis with pathological grade, progression, and survival of patients with hepatocellular carcinoma.
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DOI：
10.1038/s41598-017-12834-1
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发表时间：
2017-10-09
影响因子：
4.6
通讯作者：
Jiang GQ
中科院分区：
文献类型：
--
作者：
Bai DS;Zhang C;Chen P;Jin SJ;Jiang GQ
本研究的目的是对诊断时甲胎蛋白（AFP）水平与肝细胞癌（HCC）患者的病理分级、进展和生存期之间的临床相关性进行全面研究。对监测、流行病学和最终结果计划（SEER）登记的78，743例HCC患者进行了分析。肝癌患者的AFP检测结果主要记录为AFP阴性和AFP阳性。Logistic回归分析显示，诊断时AFP水平是影响病理分级的独立危险因素（比值比[OR]，2.559; 95%置信区间[CI]，2.075-3.157; P < 0.001），TNM-7分期（OR，2.794; CI，2.407-3.242; P < 0.001）和肿瘤大小（OR，1.748; 95% CI，1.574-1.941; P < 0.001）。多变量考克斯回归分析表明，AFP水平是未行手术的HCC患者（风险比[HR]，1.660; 95%CI，1.534-1.797; P < 0.001）和行手术的HCC患者（HR，1.534; 95%CI，1.348-1.745; P < 0.001）生存风险的独立预测因子。诊断时的AFP水平是与病理分级、进展和生存相关的独立风险预测因子。此外，与AFP阴性相比，手术可能不会显著逆转AFP阳性的不良反应。
The purpose of this study was to conduct a comprehensive study of the clinical correlation between the alpha-fetoprotein (AFP) level at diagnosis and pathological grades, progression, and survival of patients with hepatocellular carcinoma (HCC). A total of 78,743 patients in Surveillance, Epidemiology, and End Results Program (SEER)-registered HCC was analyzed. The AFP test results for patients with HCC were mainly recorded as AFP-negative and AFP-positive. Logistic regression analysis revealed that the AFP level at diagnosis was an independent risk factor of pathological grade (odds ratio [OR], 2.559; 95% confidence interval [CI], 2.075–3.157; P < 0.001), TNM-7 stage (OR, 2.794; CI, 2.407–3.242; P < 0.001), and tumor size (OR, 1.748; 95% CI, 1.574–1.941; P < 0.001). Multivariable Cox regression analyses identified AFP level as an independent predictor of survival risk of patients with HCC who did not undergo surgery (hazard ratio [HR], 1.660; 95% CI, 1.534–1.797; P < 0.001), and those who underwent surgery (HR, 1.534; 95% CI, 1.348–1.745; P < 0.001). The AFP level at diagnosis was an independent risk predictor associated with pathological grade, progression, and survival. Further, surgery may not significantly reverse the adverse effects of AFP-positive compared with AFP-negative.
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