甲胎蛋白在原发性肝癌的诊断和预后判断中的临床价值

目的：探讨癌组织和血清中的甲胎蛋白(AFP)水平与原发性肝癌(PHC)的临床特点和预后关系，为临床诊治提供依据。方法选取2004年11月至2014年6月期间顺德人民医院收治的均经组织学病理证实为新发PHC患者62例，分别应用免疫组化S-P法和化学发光免疫分析法检测所有患者的AFP，分析不同AFP水平患者的临床特点和生存时间的差异。结果 PHC患者中，肝癌组织中AFP的表达程度与血清中AFP的浓度之间呈正相关的(χ2=22.71，P<0.001，r=0.488)；PHC患者血清中AFP浓度高低与肿瘤大小有关(χ2=7.83，P=0.025)；组织中AFP表达程度与有无HBV感染有关(χ2=4.08，P=0.043)；PHC组织中AFP阳性组生存时间长于阴性组(39.0个月vs 24.9个月)，差异无统计学意义(χ2=1.90，P>0.05)。结论血清中甲胎蛋白的浓度与原发性肝癌肿瘤大小有关；HBV感染影响肝癌患者甲胎蛋白的表达量，定期监测甲胎蛋白浓度变化，有助于早期肝癌的发现。肝癌组织中AFP阳性患者生存期高于阴性，但差异无统计学意义，今后可加大样本量进行进一步的探讨。

Application of alpha-fetoprotein in the diagnosis of primary hepatic carcinoma and prediction of the ;patients'prognosis

Objective To investigate the relationship between the clinical characteristics and prognosis of prima-ry hepatic carcinoma (PHC) and alpha-fetoprotein (AFP) in cancer tissue and serum. Methods A total of 62 patients diag-nosed as PHC in the First People's of Shunde District of Foshan from November 2004 to June 2014 was enrolled. AFP in the cancer tissue and serum were detected by immunohistochemically and chemoluminescence immunoassay, respectively. The clinical characteristics and survival time in patients with different levels of AFP were analyzed. Results In patients with PHC, the expression level of AFP in cancer tissue was positively correlated serum AFP level (χ2=22.71,P<0.001,r=0.488), and the serum AFP level was significantly associated with the tumor size (χ2=7.83, P=0.025). The tissue AFP ex-pression was correlated to the status of HBV infection (χ2=4.08, P=0.043). The survival time of the patients with positive AFP was longer than that of the AFP-negative patients (39.0 months vs 24.9 months), but without significant differ-ence (χ2=1.90, P>0.05). Conclusion In patients of PHC, the serum AFP level is significantly associated with the tumor size, and HBV infection influences the expression of AFP. Regular monitoring of the AFP changes could help detect pri-mary hepatic carcinoma early. The survival time is longer in AFP-positive patients than AFP-negative patients, but with no statistically significant difference.