摘要
目的 探讨胃癌患者术前外周血甲胎蛋白信使核糖核酸（AFP mRNA）检验对术后复发转移及预后的预测价值。方法 选取2009年1月至2012年6月我院收治的胃癌手术患者100例,所有患者术前1 d取外周静脉血采用反转录·聚合酶链反应（RT-PCR）检测AFP mRNA,按照检测结果分为AFP mRNA阴性组（n=58）和AFP mRNA阳性组（n=42）。术后随访3年,观察并对比两组的术后1、2、3年复发转移率。采用Kaplan-Meier法计算两的总体生存率（OS）和无病生存率（DFS）,两组间比较Log-rank法。采用COX回归模型分析AFP mRNA阳性是否为胃癌手术患者预后的独立影响因素。结果 AFP mRNA阳性组术后1、2、3年肿瘤复发率分别为57.1%（24/42）、76.2%（32/42）、100.0%（42/42）;AFP mRNA阴性组分别为20.7%（12/58）、41.4%（24/58）、69.0%（40/58）,AFP mRNA阳性组术后3年有14.3%（6/42）发生肺转移,AFP mRNA阴性组术后3年无远处转移,AFP mRNA阳性组术后1、2、3年复发率和转移率均明显高于AFP mRNA阴性组,差异具有统计学意义（P〈0.05）;AFP mRNA阳性组术后1、2、3年OS分别为（90.1%、31.6%、10.2%）;1、2、3年DFS分别为（72.3%、22.1%、5.4%）;AFP mRNA阴性组分别为（100.0%、72.4%、25.0%）和（88.5%、52.5%、13.5%）;AFP mRNA阴性组术后1、2、3年OS和DFS均明显高于AFP mRNA阳性组,差异具有统计学意义（P〈0.05）。COX回归分析结果显示：AFP mRNA阳性是胃癌手术患者预后的独立影响因素（OR=3.294,95%CI 1.895∽6.423,P=0.001）。结论 术前外周血AFP mRNA阳性的胃癌患者术后更易发生复发转移,预后相对较差。
Objective To study the relationship of the AFP mRNA positive with the tumor recurrence and metastasis and prognosis in patients with stomach cancer postoperatively. Method Selected 100 patients with hepatoeellular carcinoma who received surgery from January 2009 to June 2012, test the AFP mRNA of the peripheral venous blood by reverse transcription polymerase chain reaction （RT-PCR） ld before the surgery, divided into AFP mRNA negative groups （11 = 59） and AFP mRNA positive group （n = 42）, according to the test results. Postoperative follow-up of 3 years, observed and compared the recurrence and transfer rate of postoperative 1, 2, 3 years of the two groups. Using the Kaplan-Meier method to calculate the overall survival （OS） rate and disease-free survival （DFS） rate, tested by the Log - rank method. Using the COX regression model to analysis the AFP mRNA positive whether the independent influence factors of the prognosis of patient received surgery. Results The tumor recurrence rate of the AFP mRNA positive group 1, 2, 3 years after the surgery respectively was 57.1% （24/42）, 76.2% （32/42）, 100.0% （42/42）; AFP mRNA negative group respectively was 20.7% （12/58）, 41.4% （24/58）, 69.0% （40/58）, 3 patients 14.3% （6/42） happened a pulmonary metastasis years in AFP mRNA positive group in 3 years, there was no distant metastasis in AFP mRNA negative groups in 3 years, the metastasis and recurrence rate of the AFP mRNA positive group 1, 2, 3 years after surgery were significantly higher than that of AFP mRNA negative groups, had statistically significant difference （P〈0.05）; 1, 2, 3 years OS rate of the AFP mRNA positive groups respectively was （90.1%, 31.6%1 10.2%）;1, 2, 3 years DFS rate respectively was （72.3%, 22.1%, 5.4%）; AFP mRNA negative group respectively was （100.0%, 72.4%, 25.0%）, and （88.5%, 52.5%, 13：5%）; the 1, 2, 3 years DFS and OS of the AFP mRNA negative groups were significantly higher than that ofAFP mRNA positive, had statistically significant difference （P〈0.05）. The results of the COX regression analysis showed that the AIP mRNA positive was independent influence factors of the prognosis of patient received surgery （OP, = 3.294, 95% CI 3.294 to 6.423, P=- 0.001）. Conclusion Stomach cancer patients with AFP mRNA positive of peripheral blood preoperative more easyer to recurrence and metastasis, had a relatively poor prognosis.
出处
《中国医药指南》
2015年第24期15-17,共3页
Guide of China Medicine
关键词
胃癌
AFP
MRNA
复发转移
预后
Stomach cancer
AFP mRNA
Recurrence
Metastasis
The prognosis
