血清AFP和CA199浓度与肝癌合并肝硬化患者肝脏切除后转归的关系

Relationship between serum AFP and CA199 concentration and hepatectomy outcome in patients with hepatocellular carcinoma complicated with cirrhosis

目的:分析肝癌合并肝硬化肝脏切除后患者甲胎蛋白(AFP)和糖类抗原199(CA199)血清浓度的变化,探讨其临床意义及与患者转归的关系。方法:选择2012年1月~2016年7月于我院行肝脏切除手术治疗的80例肝癌合并肝硬化患者为研究对象,入组患者均接受肝脏切除术,检测AFP和CA199血清浓度,术后随访3年,采用Kaplan-Meier绘制生存曲线,Pearson相关性分析AFP和CA199血清浓度的相关性。结果:术后患者组AFP和CA199血清浓度均显著降低;AFP和CA199血清浓度与病灶数、病理分期及分化程度有关;Cox回归分析显示,AFP阳性、CA199阳性是影响肝癌合并肝硬化患者术后无复发生存和总体生存的独立预后因素;AFP阳性和阴性表达患者、CA199阳性和阴性患者的无复发生存累计生存函数和总体生存累计生存函数比较差异有统计学意义;Pearson相关性显示,肝癌合并肝硬化患者AFP和CA199血清浓度呈正相关的关系。结论:AFP阳性、CA199阳性是影响肝癌合并肝硬化患者术后无复发生存和总体生存的独立预后因素,且二者或可通过共同调节参与肝癌的恶性发展,联合检测AFP和CA199血清浓度变化或可对患者预后转归的预测具一定价值。

Objective To analyze the eerum levels of AFP and CA199 in patients with hepatocellular carcinoma with hepatocirrhosis,explore its clinical significance and relationship with patient outcome.Methods 80 patients with liver cancer and cirrhosis who underwent hepatectomy in the hospital from January 2012 to July 2016 were enrolled.All patients underwent hepatectomy.On the test day and at 1 week after surgery,fasting venous blood of patients in the morning was extracted.The serum concentration of AFP and CA199 was detected.After 3 years of postoperative follow-up,Kaplan-Meier was performed to draw survival curves.Pearson correlation analysis was performed to analyze correlation between AFP and CA199 serum concentration.Results The serum concentration of AFP and CA199 was significantly decreased in postoperative patient group.The changes in serum concentration of AFP and CA199 were related to number of lesions,pathological staging and differentiation degree.Cox regression analysis showed that positive AFP and positive CA199 were independent prognostic factors influencing postoperative recurrence-free survival and overall survival in patients with liver cancer and cirrhosis.There were significant differences in cumulative survival functions of recurrence-free survival and overall survival patients among patients with positive and negative AFP expression,positive and negative CA199 expression.Pearson correlation showed there was significant positive correlation between AFP and CA199 serum concentration in patients with liver cancer and cirrhosis.Conclusion Positive AFP and CA199 are independent prognostic factors influencing postoperative recurrence-free survival and overall survival in patients with liver cancer and cirrhosis.Both of them may collectively participate in malignant development of liver cancer.Combined detection on changes in AFP and CA199 serum concentration may be of certain value in predicting prognosis outcome of patients.