CAJ | 학술논문

目的通过检测肝癌患者术后甲胎蛋白(AFP)和γ-羧基凝血酶原(DCP)水平的变化情况,评估AFP和DCP在肝癌患者预后评价中的作用.方法回顾性分析105例接受根治性切除的肝癌患者术前及术后AFP和DCP水平,并根据两指标变化情况将患者分为3组:治疗前后在正常参考值范围内(N组)；治疗前水平高于正常参考值上限,但治疗后回降至正常范围内(D组)；治疗前水平正常,但治疗后高于正常参考值上限及治疗前水平高于正常参考值上限,治疗后虽有下降但仍高于正常参考值上限,或治疗前后无改变,或治疗后水平升高(P组).再联合两种指标,将患者分为术后两指标均阴性组(A组)、AFP阳性而DCP阴性组(B组)、AFP阴性而DCP阳性组(C组)和两指标均阳性组(D组).分析两指标与患者预后的关系.结果高水平AFP和DCP与患者总体生存率和无瘤生存率密切相关.AFP-N组的3年、5年无瘤生存率(66.7％、42.8％)比D组(37.8％、27.2％)和P组(27.8％、16.1％)高；N组3年、5年总体生存率(80.1％、66.7％)高于D组(51.4％、29.7％)和P组(36.1％、l9.4％).DCP-N组的3年、5年总体生存率(77.8％、50.0％)高于P组(32.5％、22.5％).联合分析两指标,A组3年、5年总体生存率(58.8％、47.1％)和无瘤生存率(47.1％、38.2％)明显高于其他各组,而D组(25％、0；25％、6.2％)则低于其他各组；B组和C组间生存率差异不明显.结论 AFP和DCP均可独立作为肿瘤预后评价的标志分子且预后和指标阳性程度相关.联合进行两项指标检测,可以更好分析患者预后情况.
목적 통과검측간암환자술후갑태단백(AFP)화γ-최기응혈매원(DCP)수평적변화정황,평고AFP화DCP재간암환자예후평개중적작용.방법 회고성분석105례접수근치성절제적간암환자술전급술후AFP화DCP수평,병근거량지표변화정황장환자분위3조:치료전후재정상삼고치범위내(N조)；치료전수평고우정상삼고치상한,단치료후회강지정상범위내(D조)；치료전수평정상,단치료후고우정상삼고치상한급치료전수평고우정상삼고치상한,치료후수유하강단잉고우정상삼고치상한,혹치료전후무개변,혹치료후수평승고(P조).재연합량충지표,장환자분위술후량지표균음성조(A조)、AFP양성이DCP음성조(B조)、AFP음성이DCP양성조(C조)화량지표균양성조(D조).분석량지표여환자예후적관계.결과 고수평AFP화DCP여환자총체생존솔화무류생존솔밀절상관.AFP-N조적3년、5년무류생존솔(66.7％、42.8％)비D조(37.8％、27.2％)화P조(27.8％、16.1％)고；N조3년、5년총체생존솔(80.1％、66.7％)고우D조(51.4％、29.7％)화P조(36.1％、l9.4％).DCP-N조적3년、5년총체생존솔(77.8％、50.0％)고우P조(32.5％、22.5％).연합분석량지표,A조3년、5년총체생존솔(58.8％、47.1％)화무류생존솔(47.1％、38.2％)명현고우기타각조,이D조(25％、0；25％、6.2％)칙저우기타각조；B조화C조간생존솔차이불명현.결론 AFP화DCP균가독립작위종류예후평개적표지분자차예후화지표양성정도상관.연합진행량항지표검측,가이경호분석환자예후정황.
Objective To evaluate the prognosis in patients with hepatocarcinoma by examining the expression of α-fetoprotein (AFP) and des γ prothrombin (DCP).Methods Retrospectively analyzed the expression of AFP and DCP in 105 patients received curative hepatectomy.Divided the patients into three groups as follow:the tumor markers were both negative pre-and post-operation (Group N) ; the tumor markers decreased to normal after operation (Group D) ; the tumor markers kept positive or decreased but still higher positive after operation (Group P).Then combined the two markers and divided the patients into 4 groups:two markers both negative(AFP + DCP +)(Group A) ; AFP + DCP-(Group B) ; AFP-DCP + (Group C) ; AFP-DCP-(Group D).Results High AFP and DCP levels were significantly associated with poor tumor-free and overall survival.The presence of large size and advanced stage were significantly associated with Group P.Overall survival in the AFP-N group was significantly better than that of other groups and overall survival in DCP-N group were significantly better than that of the P group.After the combination,Group A had the best overall and tumor free survival rate while the D group had the worst.The differences between B and C group were not significant.Conclusions AFP and DCP can be both used solely as tumor markers and the expressions of them are associated with the prognosis.The combination of two markers can be used for better prediction of hepatocarcinoma.