甲胎蛋白（AFP）、Child-Turcotte-Pugh（CTP）评分及疾病分期对肝细胞癌（HCC）患者生存的影响：来自单一肿瘤中心的回顾性队列研究
The impact of alpha-fetoprotein (AFP), child-turcotte-pugh (CTP) score and disease staging on the survival of hepatocellular carcinoma (HCC) patients: a retrospective cohort from single oncology center.
作者信息
Mulla Nasser, Katib Yousef, Almughamsi Asim M, Alkhayat Duaa S, Mosaad Mohamed, Alfotih Samir T, Alaofi Rawan
机构信息
Department of Internal Medicine, Faculty of Medicine, Taibah University, Madinah, 42278, Saudi Arabia.
Department of Radiology, Faculty of Medicine, Taibah University, Madinah, 42278, Saudi Arabia.
出版信息
Oncol Res. 2024 Dec 20;33(1):149-160. doi: 10.32604/or.2024.050903. eCollection 2025.
BACKGROUND
Hepatocellular carcinoma (HCC) is the most common cause of cancer-related death in Saudi Arabia. Our study aimed to investigate the patterns of HCC and the effect of TNM staging, Alfa-fetoprotein (AFP), and Child-Turcotte Pugh (CTP) on patients' overall survival (OS).
METHODS
A retrospective analysis was conducted on 43 HCC patients at a single oncology center in Saudi Arabia from 2015 to 2020. All patients had to fulfill one of the following criteria: (a) a liver lesion reported as definitive HCC on dynamic imaging and/or (b) a biopsy-confirmed diagnosis.
RESULTS
The mean patient age of all HCC cases was 66.8 with a male-to-female ratio of 3.3:1. All patients were stratified into two groups: viral HCC (n = 22, 51%) and non-viral HCC (n = 21, 49%). Among viral-HCC patients, 55% were due to HBV and 45% due to HCV. Cirrhosis was diagnosed in 79% of cases. Age and sex did not significantly statistically differ in OS among viral and non-viral HCC patients (-value > 0.05). About 65% of patients had tumor size >5 cm during the diagnosis, with a significant statistical difference in OS (-value = 0.027). AFP was >400 ng/ml in 45% of the patients. There was a statistically significant difference in the OS in terms of AFP levels (-value = 0.021). A statistically significant difference was also observed between the CTP score and OS (-value = 0.02). CTP class B had the longest survival. BSC was the most common treatment provided to HCC patients followed by sorafenib therapy. There was a significant statistical difference in OS among viral and non-viral HCC patients (-value = 0.008).
CONCLUSIONS
The most common predictors for OS were the underlying cause of HCC, AFP, and tumor size. Being having non-viral etiology, a tumor size >5 cm, an AFP > 400 ng/mL, and a CTP score class C were all negatively associated with OS.
背景
肝细胞癌（HCC）是沙特阿拉伯癌症相关死亡的最常见原因。我们的研究旨在调查HCC的模式以及TNM分期、甲胎蛋白（AFP）和Child-Turcotte Pugh（CTP）对患者总生存期（OS）的影响。
方法
对2015年至2020年沙特阿拉伯一家肿瘤中心的43例HCC患者进行回顾性分析。所有患者必须符合以下标准之一：（a）动态成像报告为确诊HCC的肝脏病变和/或（b）活检确诊。
结果
所有HCC病例的患者平均年龄为66.8岁，男女比例为3.3:1。所有患者分为两组：病毒性HCC（n = 22，51%）和非病毒性HCC（n = 21，49%）。在病毒性HCC患者中，55%由乙肝病毒引起，45%由丙肝病毒引起。79%的病例诊断为肝硬化。病毒性和非病毒性HCC患者的年龄和性别在OS方面无显著统计学差异（P值>0.05）。约65%的患者在诊断时肿瘤大小>5 cm，OS有显著统计学差异（P值 = 0.027）。45%的患者AFP>400 ng/ml。AFP水平在OS方面有统计学显著差异（P值 = 0.021）。CTP评分与OS之间也观察到统计学显著差异（P值 = 0.02）。CTP B级生存期最长。最佳支持治疗（BSC）是HCC患者最常用的治疗方法，其次是索拉非尼治疗。病毒性和非病毒性HCC患者的OS有显著统计学差异（P值 = 0.008）。
结论
OS最常见的预测因素是HCC的潜在病因、AFP和肿瘤大小。非病毒病因、肿瘤大小>5 cm、AFP>400 ng/mL以及CTP评分C级均与OS呈负相关。
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