Zhou Li, Rui Jing-An, Wang Shao-Bin, Chen Shu-Guang, Qu Qiang
Department of General Surgery, Peking Union Medical College, Beijing, China.
Hepatogastroenterology. 2012 May;59(115):840-3. doi: 10.5754/hge10404.
BACKGROUND/AIMS: The significance of preoperative serum a-fetoprotein (AFP) level in hepatocellular carcinoma (HCC) treated with different modalities remains controversial. Besides, many cut-off values have been used. The present study aims to clarify significance of two major ones in HCC with cirrhosis.
One hundred and thirty eight consecutive cirrhotic patients with HCC after curative resection are included. The correlations between serum AFP level and clinicopathological parameters and patient survival are evaluated and compared when 400ng/mL and 20ng/mL are set as cut-off points.
Serum AFP level is associated with more clinicopathological variables of HCC under the cut-off value of 400ng/mL, than that of 20ng/ mL. However, serum AFP level under the cut-off value of 20ng/mL is of significant prognostic impact for both overall and tumor-free survival, whereas that under 400ng/mL is not.
The two cut-off values of preoperative AFP levels might be of different implications in cirrhotic patients with HCC after curative resection. Therefore, these might be adopted differentially in HCC.
背景/目的:术前血清甲胎蛋白(AFP)水平在接受不同治疗方式的肝细胞癌(HCC)中的意义仍存在争议。此外,已采用了许多临界值。本研究旨在阐明其中两个主要临界值在伴有肝硬化的HCC中的意义。
纳入138例接受根治性切除术后的连续性肝硬化HCC患者。当将400ng/mL和20ng/mL设为临界值时,评估并比较血清AFP水平与临床病理参数及患者生存率之间的相关性。
在临界值为400ng/mL时,血清AFP水平与HCC更多的临床病理变量相关,高于临界值为20ng/mL时。然而,临界值为20ng/mL时的血清AFP水平对总生存期和无瘤生存期均具有显著的预后影响,而临界值为400ng/mL时则不然。
术前AFP水平的这两个临界值在根治性切除术后伴有肝硬化的HCC患者中可能具有不同的意义。因此,在HCC中可能需要区别采用。