甲胎蛋白异质体AFP-L3对肝癌切除术后复发的判断价值

目的通过分析肝癌患者术前、术后血清甲胎蛋白(AFP)及其糖链异质体AFP-L3含量的变化,了解和评价AFP-L3对肝癌切除术后复发判断的价值。方法 2007年1月至12月接受首次肝细胞癌切除术的患者67例,详细记录其临床资料,同步连续测定手术前后患者血清AFP和AFP-L3含量,并进行长期复查和随访。结果全组1、2、3年总体复发率分别为23.9%(16/67)、38.8%(26/67)和50.7%(34/67)。患者术前血清AFP-L3含量与血清AFP水平之间无相关性(rs=0.176,P=0.155)。患者术前血清AFP-L3含量与肿瘤复发之间呈正相关(rs=0.327,P=0.007),而AFP含量与肿瘤复发之间相关性尚不明确(rs=0.240,P=0.051)。结论 AFP-L3与肝癌的复发有关联,对肝癌的复发判断有较高的价值,可为临床医生判断肝癌疗效提供有用的信息。

Value of serum AFP-L3 in predicting recurrence of hepatocellular carcinoma after hepatectomy

Objective To identify the changes of serum alpha-fetoprotein (AFP) and AFP-L3 levels after surgical resection of hepatocellular carcinoma (HCC), so as to evaluate the role of AFP-L3 in predicting post-operative HCC recurrence. Methods A total of 67 HCC patients who received surgical resection from Jan. 2007 to Dec. 2007 were enrolled in the present study. The detailed clinical data were obtained for each patient. Pre- and post-operative serum AFP and AFP-L3 levels were measured continuously, and patterns of their post-operative changes were followed up for a long-term period. Results The overall 1-, 2- and 3-year recurrence rates of the patients were 23.9%(16/67), 38.8%(26/67) and 50.7%(34/67), respectively. There was no relationship between serum AFP and AFP-L3 level before operation (r_s=0.176, P=0.155). The pre-operation serum AFP-L3 level was significantly correlated with tumor recurrence (r_s=0.327, P=0.007), but the relation between pre-operation serum AFP level and tumor recurrence was not clear yet(r_s=0.240, P=0.051). Conclusion Serum AFP-L3 level is associated with HCC recurrence and therefore valuable for predicting HCC recurrence; it can provide clinicians with more information for judging the therapeutic efficacy of HCC patients.