合并肝硬化中晚期肝癌TACE治疗后血清AFP监测的意义  

Monitoring value of serum AFP level for middle-late stage hepatocellular carcinoma associated with cirrhosis after treatment of transcatheterarterial chemoembolization(TACE)

作　　者：李晓晖 颜见 凌云彪 邓美海[2] 

机构地区：[1]广东省电白县水东医院外科,广东茂名525000 [2]中山大学附属第三医院外科,广州510630

出　　处：《岭南现代临床外科》2012年第3期176-178,185,共4页Lingnan Modern Clinics in Surgery

摘　　要：目的探讨合并肝硬化的中晚期肝癌患者血清AFP水平对经肝动脉化疗栓塞术(TACE)治疗预后的意义。方法收集250例TACE术后的中晚期肝癌合并肝硬化患者的血清,采用放射免疫法测定患者血清AFP的水平。将测定的结果分成AFP升高组(>20μg/L,n=165)例和正常组(<20μg/L,n=85),并对肝癌患者进行随访(1周～65个月,中位时间21.5个月)。用Kaplan-Meier生存曲线分析患者生存率,评估AFP水平及相关因素对中晚期肝癌患者预后的意义。结果 AFP升高组的1、2、5年生存率为57%、48%、5.1%,AFP正常组为37%、46%、12%。AFP升高组的1年生存率明显高于AFP正常组(P<0.05),AFP升高组5年生存率明显低于AFP正常组(P<0.05)。结论对于中晚期肝癌的患者,血清AFP水平高者较血清AFP水平低者短期预后好,但远期预后差。Objective To discuss the prognostic significance of serum AFP level for hepatocellular carcinoma （ HCC ） with cirrhosis after transcatheter arterial chemoembolization （ TACE ） treatment. Methods Serum AFP levels were measured in randomly-selected 250 HCC patients with cirrhosis who received TACE by using radioimmunoassay. The result was divided into two group： 165 cases in elevated AFP group （〉20 p^g/L） and 85 cases in normal AFP group （〈20 p^g/L）. The HCC patients were followed up for 1 week to 65 months, the median follow-up time was 21.5 months. The survival rate of HCC patients was analyzed by Kaplan -Meier survival curve, thus, we can assess the significance of the level of AFP and related factors for the prognosis of patients with advanced HCC. Results The 1-,2- and 5- year survival rate in elevated AFP group were 857% ,48% ,5.1% respectively, 37%, 46%, 12% in normal AFP group. 1-year survival rate of elevated AFP group was significantly higher than AFP normal group （P〈0.05）, but 5-year survival rate was significantly lower than normal AFP group（P〈0.05）. Conclusions The prognosis of advanced HCC with cirrhosis who received TACE depends on the number of normal hepatocytes and regeneration capacity of the liver tissue. AFP levels can reflect the regeneration of liver cells status indirectly in advanced HCC patients, the short-term prognosis of high level AFP patients were better than that of the low levels AFP patients, but long-term prognosis is worse.

关 键 词：原发性肝癌 肝硬化 甲胎蛋白(AFP) 经肝动脉化疗栓塞术(TACE) 生存率 

分 类 号：R735.7[医药卫生—肿瘤]