甲胎蛋白异质体（AFP—L3）对肝癌切除术后复发的预测价值探讨

目的探讨甲胎蛋白异质体（AFP-L3）对原发性肝癌（primarylivercancer，PLC）患者肝癌切除术后肿瘤复发转移的预测价值。方法选择2008年6月至2009年12月期间在我院接受首次肝癌切除术的48例PLC患者，同步测定患者术前、术后血清AFP和AFP—L3含量，计算AFP．L3占总AFP的百分比（以AFP-13％≥10％作为阳性判断标准）。并对患者进行长期复查和随访，以了解血清AFP和AFP．L3对PLC患者肝癌切除术后肿瘤复发转移的预后判断价值。结果48例PLC患者在随访期间共有25例发生肿瘤复发转移，随访1、2、3年的总体复发率分别为22．9％（11／48）、39．6％（19／48）、52．1％（25／48）。患者术前血清AFP—L3％与总AFP水平之间无相关性；术前、术后血清AFP—L3％与肿瘤复发转移之问均呈正相关，而术前、术后血清AFP水平与肿瘤复发之间缺乏明确的相关性。结论血清AFP．L3％与肝癌切除术后肿瘤复发有关联，对PLC患者术后复发转移的判断有重要临床价值。

Explore the value of AFP-L3 in serum for predicting recurrence of primary liver cancer after hepatectomy

Objective To discuss the value of AFP-L3 in serum for predicting recurrence and transfer of PLC post-operative. Methods Totally48 patients,with primary liver cancer （PLC） , received surgical resection from July2008 to December2009 were enrolled in the present study. The detailed clinical data were obtained for each patient. Pre-and post-operative AFP and AFP-L3 levels in serum were measured continuously, and the proportions of AFP -[3 were calculated （with cut-off value t〉 10% for AFP -I3 is positive）. The patterns of their post-operative changes were followed up for a long-term period. Results 25cases occured tumor recurrence during the follow-up period in 48 patients with PLC. The recurrence rates of the patients during the first 3 years were 22.9% （ 11/48）, 39.6% （ 19/45 ）, 52. 1% （ 25/48 ） respectively. There was no relative relationship between serum AFP and AFP-L3 level before operation. The pre- and post-operation serum AFP-I3 level was significantly correlated with tumor recurrence, but the relation between pre- and post- operation serum AFP level and tumor recurrence was not clear yet. Conclusions Serum AFP-L3 level is associated with PLC recurrence and therefore valuable for predicting PLC recurrence.