术后血清碱性磷酸酶对肝细胞肝癌切除术后复发的预测价值
摘要
目的探讨术后血清碱性磷酸酶(ALP)对肝细胞肝癌(HCC)切除术后复发的预测价值。方法收集2015年1月至2016年1月郑州大学第一附属医院接受手术治疗的108例HCC患者。采用ROC曲线模型分析ALP最佳临界值。分析ALP与HCC预后的关系。采用Cox回归分析HCC术后复发的危险因素。结果通过ROC模型确定血清ALP截断点为120 U/L,ALP>120 U/L为高表达组(50例),ALP≤120 U/L为低表达组(58例)。低表达组和高表达组HCC术后2年复发率分别为60.3%(35/58)、82.0%(41/50)。ALP高表达组HCC术后2年复发率高于低表达组,差异有统计学意义(P<0.05)。术后ALP>120 U/L和微血管浸润是HCC术后复发的独立危险因素(P<0.05)。术后ALP高表达组无瘤生存时间较低表达组短,差异有统计学意义(P<0.05)。结论术后血清ALP水平可有效预测HCC切除术后的复发。
引文
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[3] CAPUSSOTTI L,MURATORE A,AMISANO M,et al.Liver resection for hepatocellular carcinoma on cirrhosis:analysis of mortality,morbidity and survival--a European single center experience[J].Eur J Surg Oncol,2005,31(9):986-993.
[4] FAN S T,MAU L C,POON R T,et al.Continuous improvement of survival outcomes of resection of hepatocellular carcinoma:a 20-year experience[J].Ann Surg,2011,253(4):745-758.
[5] KIM S H,SHIN K H,MOON S H,et al.Reassessment of alkaline phosphatase as serum tumor marker with high specificity in osteosarcoma[J].Cancer Med,2017,6(6):1311-1322.
[6] HEINRICH D,BRULAND ?,GUISE T A,et al.Alkaline phosphatase in metastatic castration-resistant prostate cancer:reassessment of an older biomarker[J].Future Oncol,2018,14(24):2543-2556.
[7] XIE Y,WEI Z B,DUAN X W.Prognostic value of pretreatment serum alkaline phosphatase in nasopharyngeal carcinoma[J].Asian Pac J Cancer Prev,2014,15(8):3547-3553.
[8] 中华人民共和国卫生和计划生育委员会医政医管局.原发性肝癌诊疗规范(2017年版)[J].中华消化外科杂志,2017,16(7):705-720.
[9] HASEGAWA K,KOKUDO N.Surgical treatment of hepatocellular carcinoma[J].Surg Today,2009,39(10):833-843.
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[11] 杨振宇,杨涛,谭凯,等.肝细胞癌伴门静脉癌栓的治疗进展[J].中华肝胆外科杂志,2016,22(3):206-210.
[12] IMAMURA H,MATSUYAMA Y,TANAKA E,et al.Risk factors contributing to early and late phase intrahepatic recurrence of hepatocellular carcinoma after hepatectomy[J].J Hepatol,2003,38(2):200-207.
[13] YAMAMOTO K,AWOGI T,OKUYAMA K,et al.Nuclear localization of alkaline phosphatase in cultured human cancer cells[J].Med Electron Microsc,2003,36(1):47-51.
[14] DU M,CHEN L,ZHAO J,et al.Microvascular invasion (MVI) is a poorer prognostic predictor for small hepatocellular carcinoma[J].BMC Cancer,2014,14:38.