摘要
目的研究血清γ-谷氨酰转肽酶(GGT)水平与乙型肝炎相关肝细胞癌(HBV-HCC)患者手术预后的关系及其在肝细胞癌(HCC)诊断中的价值。方法收集330例HBV-HCC患者、90例乙型肝炎相关肝硬化患者(HBV-LC)及90例慢性乙型肝炎(CHB)患者病例资料,回顾性分析GGT及甲胎蛋白(AFP)水平,比较不同组间相关指标差异,使用ROC曲线分析GGT对HCC诊断的价值,使用Kaplan-Meier生存曲线及Cox风险比例模型分析GGT与HCC患者预后的关系。结果 HBV-HCC患者血清GGT(94.2 U·L^(-1))显著高于HBV-LC(78.3 U·L^(-1))和CHB对照组(34.7 U·L^(-1))(P<0.001)。血清GGT联合AFP诊断肝癌阳性率高达76.2%;分别以HBV-LC及CHB为对照组,血清GGT诊断肝癌的AUC分别为0.579,0.764。KaplanMeier生存曲线表明高GGT水平HBV-HCC患者组具有更高的肿瘤复发率(P<0.001)。Cox风险比例模型分析显示:肿瘤转移、肿瘤大小>3 cm、血管栓塞、GGT≥60 U·L^(-1)、PLT<100×10~9L^(-1)是HBV-HCC患者术后肿瘤复发的危险因素(P<0.05)。结论血清GGT检测可以提高HBV-HCC患者的检出率,高GGT是术后肿瘤复发的独立危险因素之一,应加强重视。
Objective To explore the relationship between serum gamma glutamyltransferase(GGT)level and prognosis of patients with HBV related hepatocellular carcinoma(HBV-HCC)and the diagnosis value of GGT in HBV-HCC patients.Methods Clinical data of 330 HBV-HCC patients undergoing surgery resection,90 HBV-liver cirrhosis(HBV-LC)patients and 90 chronic hepatitis B(CHB)patients were collected.Clinical features including alpha fetoprotein(AFP)and GGT were retrospectively analyzed,and the correlation indices between different groups were compared.The value of GGT for HCC diagnosis was evaluated with receiver operating characteristic(ROC)curve,and the relationship between serum GGT with prognosis of HBV related HCC patients was estimated with Kaplan-Meier curve and Cox′s proportional hazards regression model.Results Serum GGT in HBV-HCC patients(94.2 U·L-1)was significantly higher than counterparts in HBV-LC(78.3 U·L-1)and CHB(34.7 U·L-1)patients(P<0.001).There were 76.2%HBV-HCC patients detected positive of combination of serum AFP and GGT.And the area under the curve(AUC)of serum GGT was 0.579 and 0.764 respectively,with HBV-LC and CHB patients as control group.Kaplan-Meier curve revealed that HBV-HCC patients with higher GGT levels were more inclined to relapse(P<0.001).Cox′s proportional hazards regression model showed that independent risk factors of tumor recurrence included tumor metastasis,tumor size>3 cm,vessel embolism,GGT≥60 U·L-1 and PLT<100×10 9 L-1(P<0.05).Conclusions Serum GGT assay can improve the detection rate of HBV-HCC patients,and high GGT is one of the independent risk factors of postoperative tumor recurrence,which is worthy of attention.
作者
黄其峰
赵寅生
邵璇璇
金玉亮
HUANG Qifeng;ZHAO Yinsheng;SHAO Xuanxuan;JIN Yuliang(Department of Laboratory Medicine,The 105th Hospital of PLA,Hefei,Anhui 230031,China)
出处
《安徽医药》
CAS
2018年第5期878-881,共4页
Anhui Medical and Pharmaceutical Journal
