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目的探讨肝癌根治性切除术前后检测肝癌特异性甲胎蛋白(HS-AFP)对原发性肝癌(肝癌)患者病情及预后判断的临床价值。方法采用聚丙烯酰胺凝胶电泳方法(PAGE)结合蛋白印迹技术(Westernblot)分离检测,对40例肝癌患者手术切除前后的血清HS-AFP进行动态观察,并与肿瘤大小、肿瘤分期、病理分级、预后及生存期进行对比分析。结果在肿瘤≥5cm组、临床分期Ⅱa+b期组、病理分级Ⅱ~Ⅲ级各组中术前HS-AFP阳性率均明显高于肿瘤<5cm组、临床Ⅰ期组、病理Ⅰ级各组(P<0·05)。术后发生复发转移者在HS-AFP阳性组为90·9%,而阴性组为20·7%(P<0·01)。单因素及多因素分析均显示术后HS-AFP与患者预后有关(P<0·01)。结论HS-AFP有助于术前肝癌的病情判断,对肝癌术后预后判断具有重要价值。
Objective To investigate the clinical value of detecting hepatoma-specific alpha-fetoprotein (HS-AFP) in patients with primary hepatocellular carcinoma (HCC) before and after radical hepatectomy. Methods The serum HS-AFP in 40 patients with hepatocellular carcinoma before and after surgical resection was detected by polyacrylamide gel electrophoresis (PAGE) combined with Western blotting. The results were compared with the tumor size, tumor stage, pathological grade, Prognosis and survival of comparative analysis. Results The positive rate of preoperative HS-AFP in the group of tumor ≥5cm, clinical stage Ⅱa + b and pathological gradeⅡ ~ Ⅲ was significantly higher than that in the group of <5cm, stageⅠ, stageⅠ (P <0.05). Postoperative recurrence and metastasis in HS-AFP-positive group was 90.9%, while the negative group was 20.7% (P <0.01). Univariate and multivariate analysis showed that postoperative HS-AFP was associated with the prognosis of patients (P <0.01). Conclusion HS-AFP contributes to the judgment of the preoperative liver cancer and has important value in the prognosis of the postoperative liver cancer.