甲胎蛋白异质体3含量对早期肝癌的预后价值

目的 探讨甲胎蛋白异质体3(lentil lectin-reactive alpha-fetoprotein-L3,AFP-L3)的含量对早期肝癌的预后价值.方法 97例早期肝癌患者根据术前AFP和AFP-13的含量分为:(1)AFP阳性、AFP-L3阴性组(29例):AFP＞20 μg/L & AFP-13＜15%;(2)AFP-L3、AFP均低含量组(16例):15%≤AFP-L3≤50% & 20 μg/L≤AFP≤200 μg/L;(3)AFP-L3、AFP均高含量组(13例):AFP-L3＞50% & AFP＞200 μg/L;(4)AFP-L3高含量、AFP低含量组(24例):AFP-13＞50%& 20 μg/L≤AFP≤200 μg/L;(5)AFP-L3低含量、AFP高含量组(15例):15%≤AFP-L3≤50% & AFP＞200 μg/L.对各组患者的肿瘤分化程度、术后1、2、3年生存率和无瘤生存率进行分析.结果 AFP-13阴性患者的肿瘤分化程度、术后3年生存率和无瘤牛存率明显优于AFP-L3阳性患者(χ2=21.051,10.043,4.450,6.977,25.566,P＜0.05).AFP-L3高含量组患者的肿瘤分化程度、术后1、2、3年生存率和无瘤生存率明显低于低含量组(χ2=7.938,3.488,9.085,P＜0.05).结论 AFP-L3含量的增高提示肿瘤恶性程度高,预后不良,尤其是AFP水平低时.手术前后检测AFP-L3含量对于患者预后的评价具有指导意义.

Prognostic value of the content of lentil lectin-rcactive alpha-fetoprotein-L3 in early-stage hepatocellular carcinoma

Objective To explore the prognostic value of the content of lentil lectin-reactive alphafetoprotein-L3(AFP-L3)in early-stage hepatocellular carcinoma(HCC).Methods According to the content of alpha.fetoprotein(AFP)and AFP-L3 before the treatment,97 patients with early-stage HCC were divided into group A(AFP＞20 μg/L & AFP-L3＜15%,n=29),group B(15%≤AFP-13≤50% & 20 μg/L≤AFP≤200 μg/L,n=16),group C(AFP-13＞50%& AFP＞200 μg/L,n=13),group D(AFP-L3＞50% & 20 μg/L≤AFP≤200 μg/L,n=24)and group E(15%≤AFP-L3≤50%& AFP＞200 μg/L,n=15).The degree of tumor differentiation,the 1-,2-,3-year survival rates and tumor-free survival rates of the patients were analyzed.Results The degree of tumor differentiation.3-year survival rate and tumor-free survival rate of patients in group A were significantly higher than those in the other 4 groups(χ2=21.051,10.043,4.450,6.977,25.566,P＜0.05).The degree of tumor differentiation,1-,2-,3-year survival rates and tumor-free survival rates of the patients in group C and D were significantly lower than those in other 3 groups(χ2=7.938,3.488,9.085.P＜0.05).Conclusions The increase of AFP-L3 content is closely related to poorly differentiated HCC and bad prognosis.especially when the AFP Ievel is low.The detection of AFP-L3 content before and after operation is beneficial to the evaluation of the prognosis of HCC patients.