Department of Hepatobiliary Surgery, Clinical Medical College of Yangzhou University, Yangzhou, 225001, China.
Sci Rep. 2017 Oct 9;7(1):12870. doi: 10.1038/s41598-017-12834-1.
The purpose of this study was to conduct a comprehensive study of the clinical correlation between the alpha-fetoprotein (AFP) level at diagnosis and pathological grades, progression, and survival of patients with hepatocellular carcinoma (HCC). A total of 78,743 patients in Surveillance, Epidemiology, and End Results Program (SEER)-registered HCC was analyzed. The AFP test results for patients with HCC were mainly recorded as AFP-negative and AFP-positive. Logistic regression analysis revealed that the AFP level at diagnosis was an independent risk factor of pathological grade (odds ratio [OR], 2.559; 95% confidence interval [CI], 2.075-3.157; P < 0.001), TNM-7 stage (OR, 2.794; CI, 2.407-3.242; P < 0.001), and tumor size (OR, 1.748; 95% CI, 1.574-1.941; P < 0.001). Multivariable Cox regression analyses identified AFP level as an independent predictor of survival risk of patients with HCC who did not undergo surgery (hazard ratio [HR], 1.660; 95% CI, 1.534-1.797; P < 0.001), and those who underwent surgery (HR, 1.534; 95% CI, 1.348-1.745; P < 0.001). The AFP level at diagnosis was an independent risk predictor associated with pathological grade, progression, and survival. Further, surgery may not significantly reverse the adverse effects of AFP-positive compared with AFP-negative.
本研究旨在全面研究甲胎蛋白（AFP）水平与肝细胞癌（HCC）患者病理分级、进展和生存的临床相关性。分析了监测、流行病学和最终结果计划（SEER）登记的 HCC 患者共 78743 例。HCC 患者的 AFP 检测结果主要记录为 AFP 阴性和 AFP 阳性。Logistic 回归分析显示，诊断时 AFP 水平是病理分级（优势比[OR]，2.559；95%置信区间[CI]，2.075-3.157；P<0.001）、TNM-7 期（OR，2.794；CI，2.407-3.242；P<0.001）和肿瘤大小（OR，1.748；95%CI，1.574-1.941；P<0.001）的独立危险因素。多变量 Cox 回归分析确定 AFP 水平是未接受手术的 HCC 患者（危险比[HR]，1.660；95%CI，1.534-1.797；P<0.001）和接受手术的 HCC 患者（HR，1.534；95%CI，1.348-1.745；P<0.001）生存风险的独立预测因素。诊断时 AFP 水平是与病理分级、进展和生存相关的独立危险因素。此外，手术可能不会显著逆转 AFP 阳性与 AFP 阴性相比的不利影响。
