甲胎蛋白与原发性肝癌临床病理因素及预后的相关性研究

目的探讨肝细胞肝癌患者术前血清甲胎蛋白（AFP）浓度与临床病理因素、根治性肝癌切除术后复发的关系。方法回顾性分析2007年1月至2009年6月在我院及江苏省人民医院行根治性肝切除术的220例经病理诊断为肝细胞性肝癌患者的临床资料，分析术前血清AFP浓度与肝癌的病理分级、肿瘤大小、肿瘤包膜、肿瘤数目、门静脉癌栓、TNM分期及术后复发的关系。结果术前血清AFP浓度与患者肿瘤直径（x2=11．76，P〈0．05）、肿瘤包膜（x2=17．07，P〈0．05）、门静脉癌栓（x2=8．944，P〈0．05）、TNM分期（x2=4．929，P〈0．05）和术后早期复发率（x2=5．569，P〈0．05）有关，与病理Edmondson分级及肿瘤数目无关。结论本研究结果表明术前血清AFP浓度高的患者的肿瘤直径更大、无包膜、更易存在门静脉癌栓及更高的TNM分期，血清AFP浓度较高者更易早期复发，可作为判断肝细胞性肝癌术后预后差的一个标记物，可在临床上用于预测预后和复发。

Correlation of AFP with clinical pathological factors and prognosis of primary hepatic carcinoma

Objective To investigate the correlation of serum alpha-fetoprotein （AFP） with clinical pathological factors and prognosis of hepatocellular carcinoma （HCC）. Methods Two hundred and twenty patients with HCC who hospitalized in our hospital from January 2007 to June 2009 were enrolled in this study. The relationship of AFP levels before operation to clinical pathological factors such as pathological grade, tumor size, tumor encapsulation, tumor numbers, portal vein tumor thrombus, TNM stage and postoperative recurrence were analyzed. Results Serum AFP concentration before operation were related with tumor size （X2 = 11. 76, P 〈 O. 05 ）, tumor encapsulation （ X2 = 17.07, P 〈 0. 05 ）, portal vein tumor thrombus （ X2 = 8. 944,P 〈 0. 05） , higher TNM stage （ X2 = 4. 929, P 〈 0. 05 ） and early postoperative recurrence rate （ x2 = 5. 569, P 〈 0.05 ）. However,it had no correlation with pathological edmondson grade tumor numbers. Conclusion HCC patients with high serum AFP concentration often has greater tumor without encapsulation, high occurrence rate of portal vein tumor thrombus and higher TNM stage,they are more likely to early postoperative recurrence. Serum AFP before operation is useful not only for diagnosis, but also as a prognostic biomarker to predict prognosis and recurrence.