术前血清前白蛋白水平与甲胎蛋白阴性肝细胞癌患者预后的关系  

Correlation between serum prealbumin and prognosis in patients with alpha-fetoproteinnegative hepatocellular carcinoma

作　　者：王夺 梁夏宜 刘军杰[1] 陈洁[3] 陈苗[1] 李航[1] WANG Duo;LIANG Xiayi;LIU Junjie;CHEN Jie;CHEN Miao;LI Hang(Department of Ultrasound,Guangxi Medical University Cancer Hospital,Nanning 530021,China;Second Clinical Medical College of Guangxi Medical University,Nanning 530021,China;Department of Hepatobiliary Surgery,Guangxi Medical University Cancer Hospital,Nanning 530021,China)

机构地区：[1]广西医科大学附属肿瘤医院超声科,南宁530021 [2]广西医科大学第二临床医学院,南宁530021 [3]广西医科大学附属肿瘤医院肝胆外科,南宁530021

出　　处：《中国癌症防治杂志》2019年第4期323-326,共4页CHINESE JOURNAL OF ONCOLOGY PREVENTION AND TREATMENT

基　　金：国家自然科学基金项目(81860512);广西自然科学基金项目(2018GXNSFAA138006);广西高校中青年教师基础能力提升项目(KY2016YB082)

摘　　要：目的探讨术前血清前白蛋白(prealbumin,PA)对甲胎蛋白阴性的肝细胞癌(alpha-fetoprotein-negative hepatocellular carcinoma,AFP-NHCC)患者预后的影响。方法回顾性分析2014年1月至2015年12月于广西医科大学附属肿瘤医院接受肝切除术的118例AFP-NHCC患者的临床资料。根据PA临界值将患者分为低PA组(<170 mg/L)和高PA组(≥170 mg/L),采用Cox回归分析术前血清PA水平与AFP-NHCC患者预后的关系。结果术前血清PA水平与肿瘤直径、大血管侵犯、Child-Pugh分级和BCLC分期有关(P<0.05)。Kaplan-Meier 生存分析结果显示,低PA组患者的中位生存时间较高PA组短(24.5 个月vs 36.0个月,χ2=11.689,P=0.001)。Cox 回归分析显示,低PA组的死亡风险大于高PA组(HR=2.779, 95%CI:1.406~5.492,P=0.003),控制潜在混杂因素后这种关系依然存在。结论术前血清低前白蛋白水平与 AFP-NHCC患者不良预后有关,可作为评估预后的指标。Objective To investigate the effect of preoperative serum prealbumin(PA) on the prognosis of patients with alpha-fetoprotein-negative hepatocellular carcinoma(AFP-NHCC). Methods A retrospective cohort study method was performed to collect 118 AFP-NHCC patients from Guangxi Medical University Cancer Hospital from January 2014 to December 2015. According to the preoperative serum PA content demarcation value,118 AFP-NHCC patienbs were divided into low PA group(<170 mg/L) and high PA group(≥170 mg/L). Cox regression analysis was used to analyze the relationship between preoperative serum PA level and prognosis of patients with AFP-NHCC. Results Preoperative serum PA levels were associated with tumor diameter,macrovascular invasion,Child-Pugh classification,and BCLC stage(P<0.05). Kaplan-Meier survival analysis showed that the median survival time was lower in the low PA group than that in the high PA group(24.5 months vs 36.0 months,χ2=11.689,P=0.001). Cox regression analysis showed that patients with AFP-NHCC in the low PA group had a higher risk of death than those in the high PA group(HR=2.779,95%CI:1.406-5.492,P=0.003), and this relationship persisted after controlling for potential confounders. Conclusion Preoperative serum low PA levels are associated with poor prognosis in patients with AFP-NHCC and can be used as an indicator of prognosis.

关 键 词：肝细胞癌 肝切除术 前白蛋白 甲胎蛋白 预后 

分 类 号：R735.7[医药卫生—肿瘤]