摘要
目的 探究肿瘤标志物及相关血清指标水平对肝癌根治术术后生存复发的预测价值.方法 回顾性分析在2017年1月至2018年1月在我院行肝癌根治术治疗的患者298例,收集患者的临床资料情况及术前患者的肿瘤标志物、血清指标水平,并对患者进行5年随访调查,记录患者的生存复发情况,进一步探究各指标对患者生存复发情况的预测价值.结果 经单因素及多因素分析结果可知,肿瘤大小、微血管浸润、术前中性粒细胞计数、AFP、CA-125、总胆红素、血浆白蛋白水平均对患者早期复发有一定的影响,ROC曲线分析结果显示,术前中性粒细胞计数、AFP、CA-125、总胆红素、血浆白蛋白水平均对患者早期复发提供了很好的预测价值(AUC值分别为0.796、0.791、0.800、0.815、0.899);肿瘤位置、肿瘤大小、肿瘤数目、有无微血管浸润、术前FIB、前白蛋白、CA-125、CA-199、D-二聚体、HBs-Ag均对患者预后死亡有一定的预测价值,术前FIB、CA-125、CA-199、D-二聚体也对患者预后死亡有一定意义(AUC值分别为0.860、0.823、0.851、0.939).结论 术前肿瘤标志物及血清指标水平对肝癌根治术患者预后、术后复发及死亡情况具有一定预测价值.
Abstract
Objective To explore the predictive value of tumor markers and related serum indicators for survival and recur-rence after radical resection of liver cancer.Methods A retrospective analysis from January 2017 to January 2018 in 298 patients,collected clinical data and preoperative tumor markers and serum indicators,and a follow-up investigation to record the survival and re-currence of the patients and explore the predictive value of the indicators for survival and recurrence.Results According to the single factor and multifactor analysis,Tumor size,microvascular invasion,preoperative neutrophil count,AFP,CA-125,total bilirubin,and plasma albumin all impacted on the early patient recurrence,After the ROC curve analysis,It is known that preoperative neutrophil count,AFP,CA-125,total bilirubin and plasma albumin have certain predictive value for early recurrence in patients,The AUC val-ues were 0.796,0.791,0.800,0.815,and 0.899,respectively;Tumor location,tumor size,tumor number,presence of microvascu-lar invasion,preoperative FIB,prealbumin,CA-125,CA-199,D-dimer,HBs-Ag all had an influence on the prognostic death of pa-tients,According to the analysis of the ROC curve,Preoperative FIB,CA-125,CA-199,and D-dimer all have some value for the prognostic death of patients,The AUC values were 0.860,0.823,0.851,and 0.939,respectively.Conclusion Preoperative tumor marker level and serum index have certain predictive value for postoperative recurrence and death of patients with radical liver CC.
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