实验室常见检测指标对肝细胞癌预后预测价值的思考

文夏杰; 姚明解; 张玲; 鲁凤民

doi:10.3969/j.issn.1001-5256.2018.07.006

实验室常见检测指标对肝细胞癌预后预测价值的思考

DOI: 10.3969/j.issn.1001-5256.2018.07.006

1. 北京大学基础医学院病原生物学系暨感染病中心
2. 郑州大学附属肿瘤医院肝胆胰外科

详细信息

中图分类号: R735.7
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出版历程
- 收稿日期: 2018-03-30
- 出版日期: 2018-07-20

Value of common laboratory parameters in predicting the prognosis of hepatocellular carcinoma

Department of Microbiology and Infections Disease Center, School of Basic Medical Sciences, Peking University Health Science Center

摘要

摘要: 肝细胞癌（HCC）患者多有基础肝病,与其他癌症不同,HCC患者的肿瘤特征及残存肝功能均会影响到患者术后生存。为了帮助临床医生确定能够在根治性肝切除术中获益的患者,结合实验室前期研究及文献回顾,总结了对HCC患者预后有指导意义的常见临床检测指标。其中特别介绍了反映肝脏合成功能的血清学指标前白蛋白,其作为HCC患者术后独立预后因素被纳入传统Child-Pugh肝功能评价系统,形成改良的肝功能评分系统,可更加精确预测根治性肝切除术后患者的预后。这一评分系统或将有助于更加精准地选择适宜接受手术的HCC患者。
- 癌,肝细胞 /
- 预后 /
- 肿瘤标记,生物学
Abstract: Patients with hepatocellular carcinoma ( HCC) often have underlying liver diseases, and unlike other types of cancer, the features of HCC and residual liver function may affect patient survival after surgery. In order to help clinicians identify patients who can benefit from radical hepatectomy, this article summarizes common laboratory parameters which have guiding significance for the prognosis of HCC patients, with reference to preliminary laboratory studies and literature review. This article particularly introduces prealbumin, a serological marker which reflects liver synthetic function, and as an independent prognostic factor for HCC patients after surgery, prealbumin is integrated into the traditional Child-Pugh classification system to develop a modified liver function scoring system, which can accurately predict the prognosis of patients undergoing radical hepatectomy. This scoring system may help clinicians select HCC patients suitable for surgery.
- carcinoma, hepatocellular /
- prognosis /
- tumor markers, biological

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参考文献(22)

[1]CHEN W, ZHENG R, BAADE PD, et al.Cancer statistics in China, 2015[J].CA Cancer J Clin, 2016, 66 (2) :115-132.

[2]National Health and Family Planning Commission of the People's Republic of China.Diagnosis, management, and treatment of hepatocellular carcinoma (V2017) [J].J Clin Hepatol, 2017, 33 (8) :1419-1431. (in Chinese) 中华人民共和国国家卫生和计划生育委员会.原发性肝癌诊疗规范 (2017年版) [J].临床肝胆病杂志, 2017, 33 (8) :1419-1431.

[3]HEIMBACH JK, KULIK LM, FINN RS, et al.AASLD guidelines for the treatment of hepatocellular carcinoma[J].Hepatology, 2018, 67 (1) :358-380.

[4]LU FM.Serological diagnosis of hepatocellular carcinoma:challenges and opportunities[J].J Clin Hepatol, 2017, 33 (7) :1262-1265. (in Chinese) 鲁凤民.肝细胞癌的血清学诊断——挑战与希望同在[J].临床肝胆病杂志, 2017, 33 (7) :1262-1265.

[5]HSU CY, LIU PH, HO SY, et al.Impact of tumor burden on prognostic prediction for patients with terminal stage hepatocellular carcinoma:A nomogram study[J].PLo S One, 2017, 12 (11) :e0188031.

[6]SUN HC, XIE L, YANG XR, et al.Shanghai score:A prognostic and adjuvant treatment-evaluating system constructed for Chinese patients with hepatocellular carcinoma after curative resection[J].Chin Med J (Engl) , 2017, 130 (22) :2650-2660.

[7]CHENG J, WANG W, ZHANG Y, et al.Prognostic role of pretreatment serum AFP-L3%in hepatocellular carcinoma:Systematic review and meta-analysis[J].PLo S One, 2014, 9 (1) :e87011.

[8]JI J, WANG H, LI Y, et al.Diagnostic evaluation of des-gamma-carboxy prothrombin versusα-fetoprotein for hepatitis B virusrelated hepatocellular carcinoma in China:A large-scale, multicentre study[J].PLo S One, 2016, 11 (4) :e0153227.

[9]GAO P, LI M, TIAN QB, et al.Diagnostic performance of des-γ-carboxy prothrombin (DCP) for hepatocellular carcinoma:A bivariate meta-analysis[J].Neoplasma, 2012, 59 (2) :150-159.

[10]LEE S, RHIM H, KIM YS, et al.Post-ablation des-gammacarboxy prothrombin level predicts prognosis in hepatitis B-related hepatocellular carcinoma[J].Liver Int, 2016, 36 (4) :580-587.

[11]INAGAKI Y, XU HL, HASEGAWA K, et al.Des-gamma-carboxyprothrombin in patients with hepatocellular carcinoma and liver cirrhosis[J].J Dig Dis, 2011, 12 (6) :481-488.

[12]TOYODA H, KUMADA T, KANEOKA Y, et al.Prognostic value of pretreatment levels of tumor markers for hepatocellular carcinoma on survival after curative treatment of patients with HCC[J].J Hepatol, 2008, 49 (2) :223-232.

[13]XIE X, YAO M, CHEN X, et al.Reduced red blood cell count predicts poor survival after surgery in patients with primary liver cancer[J].Medicine (Baltimore) , 2015, 94 (8) :e577.

[14]XIE XM, WANG LJ, YAO MJ, et al.Correlation between red blood cell count and liver function status[J].Chin J Hepatol, 2016, 24 (2) :119-122. (in Chinese) 谢宵梦, 王雷婕, 姚明解, 等.红细胞计数与肝功能状态的关联性分析[J].中华肝脏病杂志, 2016, 24 (2) :119-122.

[15]ZHU YW, YAO MJ, BO YC, et al.Prognostic assessment of lymphocyte-to-monocyte ratio for patients with primary liver cancer after curative hepatectomy[J].J Zhengzhou Univ:Med Sci, 2017, 52 (2) :197-200. (in Chinese) 朱艺伟, 姚明解, 薄亚聪, 等.淋巴细胞与单核细胞比值对原发性肝癌患者根治性切除术后预后的预测价值[J].郑州大学学报:医学版, 2017, 52 (2) :197-200.

[16]WEN XJ, LU FM, LYU QJ.Estimate value of blood coagulation function index before surgery for survival of HBV-related hepatocellular carcinoma patients after hepatectomy[J].J Zhengzhou Univ:Med Sci, 2017, 52 (6) :725-728. (in Chinese) 文夏杰, 鲁凤民, 吕全军.术前凝血功能指标对HBV相关肝细胞癌术后生存状况的评估价值[J].郑州大学学报:医学版, 2017, 52 (6) :725-728.

[17]MA XL, GAO XH, GONG ZJ, et al.Apolipoprotein A1:A novel serum biomarker for predicting the prognosis of hepatocellular carcinoma after curative resection[J].Oncotarget, 2016, 7 (43) :70654-70668.

[18]XU XS, WAN Y, SONG SD, et al.Model based onγ-glutamyltransferase and alkaline phosphatase for hepatocellular carcinoma prognosis[J].World J Gastroenterol, 2014, 20 (31) :10944-10952.

[19]WU SJ, LIN YX, YE H, et al.Prognostic value of alkaline phosphatase, gamma-glutamyl transpeptidase and lactate dehydrogenase in hepatocellular carcinoma patients treated with liver resection[J].Int J Surg, 2016, 36 (Pt A) :143-151.

[20]VILLA L, DIOGUARDI N, AGOSTONI A, et al.Prognostic value of serum gamma-glutamyl transpeptidase activity in liver disease[J].Enzymol Biol Clin (Basel) , 1966, 7 (1) :109-114.

[21]WANG Z, SONG P, XIA J, et al.Can gamma-glutamyl transferase levels contribute to a better prognosis for patients with hepatocellular carcinoma?[J].Drug Discov Ther, 2014, 8 (3) :134-138.

[22]WEN X, YAO M, LU Y, et al.Integration of prealbumin into Child-Pugh classification improves prognosis predicting accuracy in HCC patients considering curative surgery[J].J Clin Transl Hepatol, 2018.[Epub ahead of print]

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