AFP阴性原发性肝癌临床特征及预后因素分析

doi:10.3969/j.issn.1672-5069.2020.05.028

摘要/Abstract

摘要： 目的探讨血清AFP阴性(＜20 ng/ml)的原发性肝癌(PLC)患者的临床特征及影响预后的相关因素。方法回顾性分析我院2013年3月～2017年3月住院治疗的34例AFP阴性的PLC患者的临床资料,应用SPSS 17.0统计学软件对相关资料进行处理,采用Kaplan-Meier法估计总体生存率,采用COX回归模型进行多因素分析影响AFP阴性的PLC患者预后的相关因素。结果在随访的3年中,34例患者1 a、2 a和3 a生存率分别为91.2%、85.3%和73.5%;单因素分析提示不同肿瘤大小(最大直径≤5 cm与＞5 cm)患者生存期有显著性差异(P＜0.05),远处转移灶数量＜2处与≥2处患者生存期有显著性差异(P＜0.05),有门脉癌栓与无门脉癌栓患者生存期有显著性差异(P＜0.05),Child-Pugh分级C级与A/B级患者生存期有显著性差异(P＜0.05),组织学分级高与组织学分级低患者生存期有显著性差异(P＜0.05),发生肝外转移与无转移患者生存期有显著性差异(P＜0.05),血清CEA水平高与CEA水平正常患者生存期有显著性差异(P＜0.05),TACE疗效达到CR与PD患者生存期有显著性差异(P＜0.05),进行了放疗与未进行放疗患者生存期有显著性差异(P＜0.05);COX分析提示有门脉癌栓形成、Child-Pugh分级差、组织学分化低、发生肝外转移、血清CEA水平高、TACE疗效差和未进行放疗均是影响AFP阴性PLC患者预后的独立因素(均P＜0.05)。结论 AFP阴性PLC患者预后与多种因素相关,及时行TACE治疗并达到完全缓解者或进行了补充放疗可能能延长生存期。

关键词: 原发性肝癌, 甲胎蛋白, 预后, 生存率 , ,

Abstract: Objective The aim of this study was to investigate the clinical characteristics and prognostic factors of primary liver cancer (PLC) patients with serum AFP negative (＜20 ng/ml) . Methods The clinical data of 34 patients with AFP-negative PLC were retrospectively analyzed in our hospital from March, 2013 to March, 2017. The relevant data were processed by SPSS17.0 statistical software, and the overall survival rate was estimated by Kaplan-Meier method. COX regression model was applied to analyze the prognostic factors of patients with AFP-negative PLC. Results During the 3-year follow-up, the 1-year, 2-year and 3-year survival rates of our 34 patients were 91.2%, 85.3% and 73.5%, respectively; univariate analysis showed that there was significant differences in survival period between patients with different tumor size (maximum diameter ≤ 5cm and ＞ 5cm, between patients with and without distant metastasis, between patients with and without portal vein tumor thrombus, between patients with Child-Pugh class C and those with Child-Pugh class B, between patients with high histological differentiation and low histological differentiation , between patients with distant metastasis and without metastasis, between patients with high serum CEA level and normal CEA level, between patients with CR and PD after treated with TACE, and between patients having radiotherapy and those without receivingradiotherapy(P＜0.05); COX analysis showed that portal thrombus formation, poor Child-Pugh class, low histological differentiation, distant metastasis, high serum CEA level, poor response to TACE and no radiotherapy were all the independent prognostic factors of patients with AFP negative PLC (all P＜0.05). Conclusion The prognosis of patients with serum AFP negative PLC is related to many factors, and the patients with complete remission of tumor after TACE and having radiotherapy might even have a better prognosis.

Key words: Hepatoma, AFP negative, Prognosis, Survival rate

韩鹏伟, 王虎明, 赵天永. AFP阴性原发性肝癌临床特征及预后因素分析[J]. 实用肝脏病杂志, 2020, 23(5): 715-718.

Han Pengwei, Wang Huming, Zhao Tianyong. Clinical feature and prognostic factors of primary liver cancer patients with serum AFP negative after TACE[J]. Journal of Practical Hepatology, 2020, 23(5): 715-718.

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