不同AFP水平肝细胞癌患者手术后5年生存期比较的回顾性分析

摘要/Abstract

摘要： 目的了解术前不同血清甲胎蛋白(AFP)水平的肝细胞癌患者术后5年生存率变化情况。方法回顾性分析2011年11月至2014年11月天津市第四中心医院收治的135例手术切除原发性肝细胞癌患者的临床资料,按术前血清AFP的水平分为A组(AFP≤20 ng/mL,51例)、B组(20 ng/mL＜AFP≤400 ng/mL,36例)、C组(AFP>400 ng/mL,48例)。比较3组患者血清ALT、谷氨酰转移酶(GGT)、总胆红素(TBil)、凝血酶原时间(PT)、血小板计数(PLT)、白蛋白(Alb)水平,分析3组术后1、3、5年无复发生存率及总体生存率。结果 3组PLT、ALT、GGT、TBil、Alb、PT比较无显著差异(P>0.05)。C组术后1、3、5年无复发生存率分别为54.2%(26/48)、33.3%(16/48)、27.1%(13/48),显著低于A组的78.4%(40/51)、58.8%(30/51)、41.2%(21/51)和B组的69.4%(25/36)、41.7%(15/36)、33.3%(12/36),差异均有统计学意义(均P<0.05)。C组术后1、3、5年总体生存率分别为81.3%(39/48)、52.1%(25/48)、35.4%(17/48),显著低于A组的94.1%(48/51)、82.4%(42/51)、62.7%(32/51)和B组的91.7%(33/36)、75.0%(27/36)、52.8%(19/36),差异均有统计学意义(均P<0.05)。结论术前血清AFP水平与肝细胞癌患者预后密切相关。

关键词: 甲胎蛋白, 肝细胞癌, 肝切除术, 生存率

Abstract: Objective To study on the differences of 5-year post-operative survival rate of hepatocellular carcinoma (HCC) patients with various serum alpha fetoprotein (AFP) levels prior to the operation. Methods The clinical data of 135 patients who received surgical resection in our hospital from November 2011 to November 2014 were retrospectively analyzed. According to their serum AFP levels before operation, the patients were divided into group A (51 cases, with AFP≤20 ng/mL), group B (36 cases, with 20 ng/mL < AFP≤400 ng/mL) and group C (48 cases, with AFP > 400 ng/mL). Parameters of platelet (PLT), alanine aminotransferase (ALT), gamma glutamyltransferase (GGT), total bilirubin (TBil), albumin (Alb), and prothrombin time (PT) were compared, and the relapse-free survival rate and overall survival rate were analyzed at 1, 3 and 5 years after operation. Results There were no significant differences in PLT, ALT, GGT, TBil, Alb and PT among these three groups (P>0.05). The recurrence free survival rates at 1, 3 and 5 years after operation in group C were 54.2% (26/48), 33.3% (16/48), 27.1% (13/48), respectively, which were significantly lower than 78.4% (40/51), 58.8% (30/51), 41.2% (21/51) in group A, and 69.4% (25/36), 41.7% (15/36), 33.3% (12/36) in group B (P<0.05). The overall postoperative survival rates at 1, 3 and 5 years in group C were 81.3% (39/48), 52.1% (25/48), 35.4% (17/48), respectively, which were significantly lower than 94.1% (48/48), 82.4% (42/51), 62.7% (32/51) in group A, and 91.7% (33/36), 75.0% (27/36), 52.8% (19/36) in group B (P<0.05). Conclusion Preoperative serum AFP levels are closely associated with the prognosis of HCC.

Key words: Alpha fetoprotein, Hepatocellular carcinoma, Hepatectomy, Survival rates

张志生, 孔庆利, 梁志鹏. 不同AFP水平肝细胞癌患者手术后5年生存期比较的回顾性分析[J]. 肝脏, 2020, 25(8): 813-815.

ZHANG Zhi-sheng, KONG Qing-li, LIANG Zhi-peng. A retrospective analysis of 5-year post-operative survival rate of hepatocellular carcinoma patients with different AFP levels[J]. Chinese Hepatolgy, 2020, 25(8): 813-815.

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