具有正常血清甲胎蛋白水平的肝细胞癌患者的临床特征：连

StephenW

Asia Pac J Clin Oncol. 2017 Oct 26. doi: 10.1111/ajco.12816. [Epub ahead of print]
Clinical characteristics of hepatocellular carcinoma patients with normal serum alpha-fetoprotein level: A study of 112 consecutive cases.Li L1, Chen J2, Xu W1, Ding X1, Wang X1, Liang J1.
Author information
1Department of Oncology, Peking University International Hospital, Beijing, China.2Department of Oncology, Beijing Ditan Hospital, Capital Medical University, Beijing, China.

AbstractBACKGROUND: Serum alpha-fetoprotein (AFP) level is normal in 30-40% of hepatocellular carcinoma (HCC) patients, and knowledge on its characteristics and clinical outcome is limited. The purpose of this observational study was to determine the clinical presentation, biological behavior and outcome of HCC patients with normal AFP level.
METHODS: Data of 112 consecutive HCC patients with normal AFP level were analyzed retrospectively. Statistical analysis including survival and factors associated with serum AFP level were performed by Kaplan-Meier method and t-test, respectively.
RESULTS: Hepatitis B virus infection exited in 83.0% of all 112 HCC patients with normal AFP level. During a mean 52 ± 20 months (range 5-85 months) follow-up, the 1-, 2-, 3-year overall survival (OS) rate was 97.2%, 85.3% and 81.7%, respectively. The OS rates at 3 years stratified by stages at diagnosis were 100%, 96.2%, 85.7%, 11.1% and 0%, respectively for Barcelona Clinic Liver Cancer (BCLC) stage 0-D diseases. Significant difference in OS was observed among patients with BCLC stage 0-D diseases, P < 0.05. Using 8.78 ng/mL as the cut off value, serum AFP level elevated beyond normal figure during follow-up (AFP conversion) in 16 patients, which related with deterioration of liver function, quantitative changes of T helper cell subsets, rapid tumor progression and shorter survival. Patients with sustained normal AFP level had better survival than patients with AFP conversion, P < 0.05. There was significant difference between the time of diagnosis with HCC to serum AFP level elevation and the time of AFP elevation to death, P < 0.05.
CONCLUSION: Prognosis of HCC patients with normal AFP level was relatively optimal. Serum AFP level elevation during follow-up was significantly associated with clinical outcome in terms of OS.

© 2017 John Wiley & Sons Australia, Ltd.

KEYWORDS: AFP conversion; clinical characteristics; hepatocellular carcinoma; prognosis; sustained normal serum AFP level

PMID:29071776DOI:10.1111/ajco.12816

StephenW

亚洲Pac J Clin Oncol 2017年10月26日。doi：10.1111 / ajco.12816。 [提前印刷]
具有正常血清甲胎蛋白水平的肝细胞癌患者的临床特征：连续112例的研究。
李丽，陈J2，徐W1，丁X1，王X1，梁杰1。
作者信息

1
    北京大学国际医院肿瘤科，北京，中国。
2
    首都医科大学北京Ditan医院肿瘤科，北京，中国。

抽象
背景：

血浆甲胎蛋白（AFP）水平在30-40％的肝细胞癌患者中是正常的，其特征和临床结果的知识有限。该观察性研究的目的是确定具有正常AFP水平的HCC患者的临床表现，生物学行为和结果。
方法：

回顾性分析112例连续HCC正常AFP水平患者的资料。通过Kaplan-Meier法和t检验分别进行统计学分析，包括与血清AFP水平相关的生存和因素。
结果：

乙型肝炎病毒感染在正常AFP水平的112例HCC患者中排除83.0％。在平均52±20个月（5-85个月）的随访期间，1年，2年，3年总生存（OS）率分别为97.2％，85.3％和81.7％。诊断分期3年的OS率分别为巴塞罗那诊所肝癌（BCLC）0期疾病分别为100％，96.2％，85.7％，11.1％和0％。 BCLC 0-D期疾病患者OS差异有统计学意义（P <0.05）。使用8.78 ng / mL作为切断值，16例患者随访期间血清AFP水平升高超过正常值（AFP转化），与肝功能恶化，T辅助细胞亚群定量变化，肿瘤快速进展和更短的生存。患有正常AFP水平的患者生存率高于AFP转换患者，P <0.05。 HCC诊断时间与血清AFP水平升高与AFP升高时间呈显着性差异，P <0.05。
结论：

正常AFP水平的HCC患者的预后相对较好。随访期间血清AFP水平升高与OS的临床结果显着相关。

©2017 John Wiley＆Sons澳大利亚有限公司
关键词：

法新社临床特点;肝细胞癌;预后;持续正常血清AFP水平

结论：
    29071776
DOI：
    10.1111 / ajco.12816