摘要
目的探讨解剖性肝切除术对肝癌患者外周血黑色素瘤抗原-1(MAGE-1)mRNA、甲胎蛋白(AFP)mRNA的影响及临床疗效。方法回顾性选取2013年3月至2015年6月治疗的原发性肝细胞癌患者117例,根据患者最终选取的手术方式分为观察组(n=69)和对照组(n=48)。观察组采用解剖性肝切除术,对照组给予非解剖性肝切除术。观察两组手术情况,术前、术后7 d的丙氨酸氨基转移酶(ALT)、谷氨酸氨基转移酶(AST)、总胆红素(TBIL)、胆碱酯酶(CHE),以及术前、术后28 d外周MAGE-1 mRNA和AFP mRNA变化,随访观察患者总体生存时间和无进展生存期。结果观察组手术时间和切缘有效率明显高于对照组(P<0.05);观察组术后7 d ALT和AST水平明显低于对照组(P<0.05);观察组和对照组术后7 d TBIL和CHE比较,差异无统计学意义(P>0.05);观察组术后28 d MAGE-1mRNA和AFP mRNA阳性率明显低于对照组(P<0.05);观察组中位总体生存时间和中位无进展生存期也明显高于对照组(P<0.05)。结论解剖性肝切除术有较好的临床效果,可改善肝功能,降低外周血MAGE-1 mRNA和AFP mRNA表达,改善患者预后。
Objective To investigate the effect of anatomical resection and influence on melanoma antigen-1(MAGE-1)mRNA and alpha fetoprotein(AFP)mRNA in peripheral blood of patients with hepatocellular carcinoma and its clinical efficacy.Methods 117 patients with primary hepatocellular carcinoma treated from March 2013 to June 2015 were selected,the patients were divided into the observation group(n=69)and the control group(n=48)according to the final choice of operation,the observation group was given anatomical resection,and the control group was given non anatomical resection,the operation and the changes of ALT,AST,TBIL,CHE,MAGE-1 mRNA and AFP mRNA in the two groups were observed,the overall survival and progression free survival were followed up.Results The operation time,cutting edge effective rate of the observation group was significantly higher than that of the control group(P<0.05).The postoperative 7 d,ALT and AST in the observation group were(120.01±32.27)U/L and(134.28±40.13)U/L,respectively,which were significantly lower than those in the control group(P<0.05).There was no significant difference in postoperative 7 d TBIL and CHE between the observation group and the control group(P>0.05).The positive rates of postoperative 28 d MAGE-1 mRNA and AFP mRNA in the observation group were respectively significantly lower than those in the control group(P<0.05).The median overall survival time and median progression free survival in the observation group were significantly higher than those in the control group(P<0.05).Conclusion Anatomical resection has good clinical effect,can improve liver function,patients can get better prognosis,reduce the expression of MAGE-1 mRNA and AFP mRNA in peripheral blood.
作者
李凤山
王振勇
王铁功
柴伟
刘汝海
LI Feng-shan;WANG Zhen-yong;WANG Tie-gong(Department of General Surgery,Cangzhou Central Hospital,Cangzhou Hebei 061001,China)
出处
《临床和实验医学杂志》
2018年第8期838-841,共4页
Journal of Clinical and Experimental Medicine
