HS-AFP对原发性肝癌病情及手术预后判断的价值

The value of HS-AFP in predicting severity and postoperative prognosis in hepatocellular carcinoma

目的探讨肝癌根治性切除术前后检测肝癌特异性甲胎蛋白（HS-AFP）对原发性肝癌（肝癌）患者病情及预后判断的临床价值。方法采用聚丙烯酰胺凝胶电泳方法（PAGE）结合蛋白印迹技术（Western blot）分离检测，对40例肝癌患者手术切除前后的血清HS-AFP进行动态观察，并与肿瘤大小、肿瘤分期、病理分级、预后及生存期进行对比分析。结果在肿瘤≥5cm组、临床分期Ⅱa＋b期组、病理分级Ⅱ～Ⅲ级各组中术前HS-AFP阳性率均明显高于肿瘤〈5cm组、临床工期组、病理Ⅰ级各组（P〈0．05）。术后发生复发转移者在HS-AFP阳性组为90．9%，而阴性组为20．7％（P〈0．01）。单因素及多因素分析均显示术后HS-AFP与患者预后有关（P〈0．01）。结论HS-AFP有助于术前肝癌的病情判断，对肝癌术后预后判断具有重要价值。

Objective To investigate the clinical value of hepatoma-specific alpha-fetoprotein （HS-AFP） in predicting the severity and postoperative prognosis in the patients with hepatocellular carcinoma. Methods HS-AFP was separated with PAGE and determined with Western blot. HS-AFP was measured in 40 cases with hepatocellular carcinoma before and after radical excision. The correlations were analyzed between the index and tumor size, stage, differentiation, prognosis as well as survival rate. Results Before operation,the positive rate of HS-AFP in the cases with tumor size more than 5 cm,stage Ⅱ a＋b and pathological grade Ⅱ-Ⅲ was significantly higher than that with the tumor size less than 5 cm, stage Ⅰ and pathological grade Ⅰ （P〈0.05）. After operation, the recurrence and distant metastasis rate in groups with positive HS-AFP was 90.9 %, which in groups with negative HS-AFP was 20. 7 % （P〈0. 01）. Both univariate and multivariate analysis revealed that HS-AFP after operation was closely related to the prognosis of hepatocellular carcinoma（P〈0. 01）. Conclusion HS-AFP is useful in the judgement of the severity of hepatocellular carcinoma before operation. Particularly, it is valuable for the judgement of prognosis after radical excision.