摘要
目的探讨原发性肝癌肝移植患者术前外周血AFP表达水平与生存率的关系。方法回顾性分析我科2001年12月～2006年12月间234例肝癌肝移植患者的临床资料，按术前外周血AFP表达水平分为3组：A组：AFP〈20μg／L，B组：AFP〈400μg／L，C组：AFP≥400μg／L，用SPSSll．0软件进行统计分析，Kaplan-Meier法计算累积／无瘤生存率，Long-ran法检验组间差异，Cox模型进行预后多因素分析。结果全组随访1～56个月，随访期间死亡85例（36．3％），复发70例（29．9％）。患者6个月、1、2、3、4年累积生存率分别为88．5％、76．3％、61．3％、53．6％、47．6％；6个月、1、2、3年无瘤生存率分别为80．1％、70．6％、60．4％、52．3％。A、B两组患者6个月、1、2、3、4年累积／无瘤存活率均明显高于C组（P〈0．05），而两组之间差异无显著性（P〉0．05）；Cox回归多因素分析显示：术前AFP水平、肿瘤类型、大血管侵犯和肿瘤分化程度是影响预后的独立因素。结论术前外周血AFP表达水平是肿瘤复发和影响患者生存的危险因素，可作为预后的判断因子。
Objective To evaluate the relationship between pre-transplantation α-fetoprotein expression in peripheral blood with survival rate in hepatic cancer patients. Methods From December 2001 to December 2006, 234 patients underwent liver trans-plantation for hepatic carcinoma in our institute were enrolled for reviewing their clinical records. According to the AFP level, they were divided into 3 groups： Group A： AFP〈20 μg/L, Group B： AFP 〈400 μg/L, Group C： AFP≥400 μg/L. SPSSll. 0 software was used for statistical analysis. The Kaplan-Meier method,Log-rank test, and Cox regression model were used to evaluate the cumulative/ tumor-free survival rates ,the differentiations between the two groups, and the multi-factors of prognosis respectively. Results The follow-up time ranged from 1 to 56 months. The mortality was 36. 3%. The recurrence rate was 29.9%. The 6-month, 1,2,3 and 4 year patient cumulative survival rates were 88.5% ,76. 3% ,61.3% ,53.6% and 47.6%, respectively, while the 6 month, 1,2 and 3 year tumor-free survival rates were 80. 1% ,70. 6% ,60. 4% and 52. 3%, respectively. The 6 month, 1,2,3 and 4 year patient cumulative/ tumor-free survival rates in group A,B were significantly higher than that of group C（P〈0.05 ）, while there were no significant differences between the 2 groups （P〉0.05 ）. Multivariate Cox regression analysis showed that the serum AFP level, tumor type, histological differentiation and macro-vascular invasive were independent factors of prognosis. Conclusion The results suggest that the pretransplantation levels of AFP in peripheral blood may be a risk factor for recurrence and survival rates, and can be used for predicting prognosis.
出处
《肝胆外科杂志》
2007年第5期330-333,共4页
Journal of Hepatobiliary Surgery
关键词
肝脏肿瘤
肝移植
甲胎蛋白
统计学
多因素分析
hepatic tumor
liver transplantation
alpha-fetoprotein
statistical
muti-factors analysis
