联合检测血清甲胎蛋白、γ-谷氨酰转肽酶和a—L-岩藻糖苷酶对肝细胞癌根治术后转移复发的预测价值

The predictive value of recurrence and metastasis by combined assessment of AFP, GGT and AFU for patients with HCC after radical resection

目的探讨血清甲胎蛋白（AFP）、γ-谷氨酰转肽酶（GGT）和a—L-岩藻糖苷酶（AFU）对肝细胞癌（HCC）根治术后转移复发的预测价值。方法收集我院2005年12月至2007年12月80例HCC根治术后患者的术前术后血清AFP、GGT、AFU检测结果及随访资料，对比分析AFP、GGT、AFU与转移复发及1年无瘤生存率（DFS）的关系。结果80例肝癌患者术后AFP、GGT、AFU阳性率分别为25．0％、51．2％和28．6％，术后发生复发转移者在AFP、GGT和AFU阳性组分别为75．0％、73．2％和87．0％，1年DFS分别为45．0％、36．6％和13．0％。而阴性组分别为38．3％、20．5％和31．6％，1年DFS分别为75．0％、94．9％和89．5％。术后AFP、GGT和AFU三者均为阳性组患者均有复发转移，其1年DFS为0。而三者均为阴性组患者复发转移率为17．6％，其1年DFS为97．1％。结论联合检测AFP、GGT、AFU可明显提高对转移复发预测的阳性率，且对于术后转移复发的预测价值优于单项检测。

Objective To explore the predictive value of recurrence and metastasis value by com- bined assessment of alpha-fetoprotein （AFP） , gamma-glutamyl transferase （GGT） and alpha-L-fueosidse （AFU） for patients with hepatocellular carcinoma （HCC） after radical resection. Methods Eighty patients with HCC after radical resection from December 2005 to December 2007 were enrolled in this study. The data of preoperative and postoperative AFP, GGT and AFU levels, tumor recurrence and metastasis rate and one-year disease free survival （DFS） of the patients were analyzed. The relations between each marker （AFP, GGT and AFU） or their combination with tumor recurrence and metastasis rate and one-year DFS were studied. Results The postoperative positive rate of AFP, GGT and AFU was 25.0% , 51.2% and 28.6% respectively. The recurrence and metastasis rate postoperation in the groups positive for AFP, GCT and AFU was 75.0% ,73.2% and 87.0% respectively, and the one-year DFS was 45.0% ,36.6% and 13.0% respectively,while that in the groups negative for AFP, GGT and AFU was 38.3% ,20.5% and 31.6% respectively, and the one-year DFS was 75.0% ,94.9% and 89.5 % , respectively. Recurrence and metastasis occurred in all cases positive for AFP, GGT and AFU, and the one-year DFS was 0, whereas after surgery that in the cases negative for AFP, GGT and AFU accounted for only 17.6% ,and the one-year DFS was 97.1%. Conclusion The levels of GGT, AFU and AFP after radical resection were related to the tumor recurrence and metastasis. The combined evaluation of these three markers may be more helpful to increase the positive rate of predicting recurrence and metastasis of HCC patients than the marker alone.