术前血液生化指标与原发性肝细胞癌预后的关系
Relationship between preoperative blood biochemical indexes and prognosis of primary hepatocellular carcinoma patients

目的:探讨血清门冬氨酸氨基转移酶(AST)、谷氨酸氨基转移酶(ALT)、碱性磷酸酶(ALP)、总胆红素、白蛋白(ALB)、甲胎蛋白(AFP)等术前血液生化指标对经手术治疗的原发性肝细胞癌(HCC)患者术后生存时间的影响,为HCC患者的手术预后判断提供依据。方法:收集接受手术的原发性HCC患者500例,对其进行随访观察,采用Kaplan-Meier法和Log-rank检验进行生存分析,将生存分析中有意义的因素引入Cox回归模型。结果:AFP、AST、ALP、ALB是影响经手术治疗的HCC患者术后生存时间的独立危险因素[RR(95%CI)分别为1.779(1.330～2.308)、1.391(1.049～1.843)、2.063(1.497～2.844)、0.636(0.493～0.821)]。结论:术前检测AFP、AST、ALP、ALB对原发性HCC患者手术预后判断具有重要价值。
Aim: To investigate the value of aspartate aminotransferase(AST), alanine aminotransferase(ALT), alkaline phosphatase(ALP), total bilirubin, albumin(ALB), alpha fetoprotein(AFP)and other biochemical indexes of blood in predicting postsurgical survival time of the patients with primary hepatocellular carcinoma(HCC), and provide basis for surgeons' clinical treatment.Methods: A total of 500 patients with primary HCC underwent hepatectomy were followed up. Survival analysis was carried out using Kaplan-Meier method and Log-rank test. The multivariate analysis was conducted using Cox proportional hazard model.Results: AFP,AST,ALP,and ALB were independent risk factors for survival time of the patients with primary HCC[RR(95%CI)=1.779(1.330-2.308),1.391(1.049-1.843),2.063(1.497-2.844), and 0.636(0.493-0.821)].Conclusion: AFP,AST,ALP,and ALB could be used as prognostic indexes for patients with primary HCC before operation