摘要
目的探讨原发性肝细胞癌(PHCC)患者根治术前γ-谷氨酰转移酶(GGT)、谷丙转氨酶与谷草转氨酶比值(alanine aminotransferase and aspartate aminotransferase ratio,LSR)与其预后的关系,为PHCC术后患者的后续治疗及提高生存质量提供帮助。方法回顾性分析2009年12月至2013年12月间在温州医科大学附属第一医院行根治性切除术的179例PHCC患者的临床资料,将患者分为正常GGT组(GGT值<36 U/L,n=75)和高GGT组(GGT值≥36 U/L,n=104),以及低LSR组(LSR值<1.19,n=129)和高LSR组(LSR值≥1.19,n=50),分别比较分析组间患者的临床病理特征及总体生存率之间的差异。结果 179例PHCC患者术后的平均生存时间为56.59个月,高GGT组及低LSR组患者术后3、5年总体生存率分别低于正常GGT组及高LSR组患者(P<0.05)。单因素分析结果显示,肿瘤最大径≥3 cm、TNM分期、高GGT值、低LSR值是影响PHCC患者术后总生存率的危险因素(P<0.05)。多因素分析结果显示,TNM分期、高GGT值是行PHCC根治性切除术患者预后的独立危险因素(P<0.05)。结论术前GGT值、LSR值以及TNM分期同行根治性手术的PHCC患者的预后密切相关,即高GGT值、低LSR值及肿瘤分期越晚期的患者预后更差,并且术前高GGT值、TNM分期是其独立的危险因素。
Objective To investigate the relationship between preoperative γ-glutamyltransferase （GGT）, alanine aminotransferase and aspartate aminotransferase ratio （LSR） and prognosis after radical surgery for primary hepatocellular carcinoma （PHCC）. To provide help for the follow-up treatment of patients after radical surgery of primary hepatocellular carcinoma and to improve the quality of life them. Methods The clinical data of 179 PHCC patients underwent radical resection from Dec. 2009 to Dec. 2013 in the First Affliated Hospital of Wenzhou Medical University was retrospectively analyzed. The patients were divided into normal GGT values group （GGT values 〈 36 U/L, n=75） and high GGT values group （GGT values≥ 36 U/L, n=104）, as well as the low LSR values group （LSR values 〈 1.19, n=129） and the high LSR values group （LSR values ≥ 1.19, n=50）. The clinical pathological features and overall survival rates of the above-mentioned grouped patients were compared and analyzed. Results The average survival time of 179 PHCC patients after surgery was 56.59 months. The postoperative overall survival rate of patients in high GGT values group was signifcantly lower than that in normal GGT group, and low LSR values group was signifcantly lower than that in high LSR group, respectively （P〈0.05）. Univariate analysis showed that the maximum tumor size ≥3 cm, tumor stage, high GGT values, and low LSR values were risk factors for postoperative overall survival in patients with PHCC （P〈0.05）. Multivariate analysis showed that tumor stage and high GGT values were independent risk factors for PHCC patients with radical resection （P〈0.05）. Conclusion Preoperative GGT values, LSR values and TNM stage are closely related to the prognosis of PHCC patients underwent radical resection, that means, high GGT values, low LSR values and TNM stage have a worse prognosis. And preoperative GGT values and TNM stage are independent risk factors.
作者
陈磊
张理想
周超军
张演
杨文军
CHEN Lei;ZHANG Li-Xiang;ZHOU Chao-jun;ZHANG Yan;YANG Wen-jun(Department of Hepatoliary Surgery,the First Affiliated Hospital of Wenzhou Medical University,Wenzhou,Zhejiang 325000,China)
出处
《肝胆胰外科杂志》
CAS
2018年第6期448-452,共5页
Journal of Hepatopancreatobiliary Surgery
基金
浙江省自然科学基金项目(LY13H030007)
关键词
癌
肝细胞
Γ-谷氨酰转移酶
谷丙转氨酶与谷草转氨酶比值
根治性切除术
预后
primary hepatocellular carcinoma
γ-glutamyltransferase
alanine aminotransferase and aspartate aminotransferase ratio
radical resection
prognosis
