CAJ | 학술논문

目的研究血清甲胎蛋白(alpha-fetoprotein,AFP)水平与儿童肝母细胞瘤临床特征之间的关系.方法回顾性分析74例肝母细胞瘤病例,总结血清AFP数值与临床分期、治疗过程和预后之间的关系.结果本组74例中,Ⅰ期和Ⅱ期患者血清AFP平均值为(36 333±13 782) ng/ml,Ⅲ期和Ⅳ期患者血清AFP平均值为(78 346±27 956)ng/nl,两者比较差异有统计学意义,P ＜0.05.术前化疗患者68例,化疗后血清AFP下降＞50％的44例,血清AFP下降＞90％的20例,化疗后血清AFP上升有13例.15例患者于术后第1天检测血清AFP含量,其中10例较术前下降＞50％,3例较术前下降＜50％,2例较术前升高.术后获得随访52例,3年生存率为86％,7例复发,4例死亡.7例复发患者的术前血清AFP平均值为(27 060±3 569) ng/ml,3年生存组术前血清AFP平均值为(29 865±5 867) ng/ml,两者相比差异无统计学意义,P＞0.05.术后复发患者中血清AFP于第1次手术后1个月内仅57％降至正常,而术后3年无瘤生存者中89％在第1次术后血清AFP在1个月内降到正常(P＜0.05).结论肝母细胞瘤患者血清AFP水平与病情相关,可作为临床评估化疗效果的参考.术后血清AFP数值在4周内降至正常提示患者的预后良好,治疗前血清AFP水平与肝母细胞瘤的预后无相关性.
목적 연구혈청갑태단백(alpha-fetoprotein,AFP)수평여인동간모세포류림상특정지간적관계.방법 회고성분석74례간모세포류병례,총결혈청AFP수치여림상분기、치료과정화예후지간적관계.결과 본조74례중,Ⅰ기화Ⅱ기환자혈청AFP평균치위(36 333±13 782) ng/ml,Ⅲ기화Ⅳ기환자혈청AFP평균치위(78 346±27 956)ng/nl,량자비교차이유통계학의의,P ＜0.05.술전화료환자68례,화료후혈청AFP하강＞50％적44례,혈청AFP하강＞90％적20례,화료후혈청AFP상승유13례.15례환자우술후제1천검측혈청AFP함량,기중10례교술전하강＞50％,3례교술전하강＜50％,2례교술전승고.술후획득수방52례,3년생존솔위86％,7례복발,4례사망.7례복발환자적술전혈청AFP평균치위(27 060±3 569) ng/ml,3년생존조술전혈청AFP평균치위(29 865±5 867) ng/ml,량자상비차이무통계학의의,P＞0.05.술후복발환자중혈청AFP우제1차수술후1개월내부57％강지정상,이술후3년무류생존자중89％재제1차술후혈청AFP재1개월내강도정상(P＜0.05).결론 간모세포류환자혈청AFP수평여병정상관,가작위림상평고화료효과적삼고.술후혈청AFP수치재4주내강지정상제시환자적예후량호,치료전혈청AFP수평여간모세포류적예후무상관성.
Objective To analyze the relationship between the clinical features of hepatoblastoma and serum alpha-fetoprotein level.Methods We did a retrospective study in 74 cases into the relationship of clinical stages,treatment,prognosis,and AFP value in hepatoblastoma.Results In Stage Ⅰ and Ⅱ patients,the average AFP was (36 333 ± 13 782) ng/ml and in Stage Ⅲ and Ⅳ,the average AFP was (78 346 ± 27 956) ng/ml,P ＜ 0.05.68 patients received preoperative chemotherapy with alpha-fetoprotein determinations before and after chemotherapy respectively.In 44 cases AFP decreased ＞ 50％ after chemotherapy,and in 20 cases AFP declined ＞90％,while in 13 cases AFP increased after chemotherapy.15 cases had serum AFP measured on the first postoperative day,among them 10 cases had a ＞ 50％ AFP decline,3 cases had a ＜ 50％ AFP decline,while in 2 cases AFP value increased.52 cases were postoperatively followed-up,with overall 3 year-survival rate of 86.5％ ; 7 cases recurred,4 died.The average preop AFP level in 7 recurred cases was (27 060 ± 3 569) ng/ml,while the average preop AFP level in those of 3-year recurrence-free was (29 865 ± 5 867) ng/ml,P ＞ 0.05.Only 57％ tumor recurred cases had back to normal AFP level within one month postop,while 89％ long term survivals reported normal range of AFP during that period,P ＜ 0.05.Conclusions Serum AFP level in patients with hepatoblastoma is related to the course of disease.It can be used to estimate the effect of clinical chemotherapy.The speed of alpha-fetoprotein decline postop can be used as an indicator of prognosis.The postoperative normal AFP level within 4 weeks predicts a favorable prognosis.