摘要
【目的】探讨血清谷丙转氨酶/谷草转氨酶(ALT/AST)联合癌胚抗原(CEA)预测肝细胞癌术后患者预后的价值。【方法】本院经手术治疗的91例肝细胞癌患者,术后随访3年,统计存活情况,比较死亡和存活患者的临床相关资料,分析影响死亡的因素及血清ALT/AST联合CEA预测预后的价值。【结果】91例患者失访9例,其余82例中,共28例死亡,54例存活。死亡组患者低分化、Child-Pugh分级B级、远处转移构成比及血清CEA水平均高于存活组(P<0.05),死亡组患者ALT/AST低于存活组(P<0.05)。远处转移、ALT/AST、CEA是影响患者死亡的独立危险因素(OR=4.158、4.039、4.067,P<0.05);血清ALT/AST联合CEA预测肝细胞癌患者术后死亡的特异度和曲线下面积(AUC)分别为96.30%和0.946,其预测价值高于ALT/AST、CEA单独检测。【结论】临床检测血清ALT/AST和CEA可作为预测肝细胞癌患者术后死亡的敏感指标,二者联合检测的预测价值更高。
【Objective】To investigate the predictive value of serum alanine aminotransferase/aspartate aminotransferase(ALT/AST)combined with carcinoembryonic antigen(CEA)for postoperative prognosis in patients with hepatocellular carcinoma(HCC).【Methods】Ninety-one HCC patients treated surgically in our hospital were followed up for three years postoperatively.The survival status was recorded,and clinical data of deceased and surviving patients were compared.Factors influencing mortality and the predictive value of serum ALT/AST combined with CEA for prognosis were analyzed.【Results】Of the 91 patients,9 were lost to follow-up.Among the remaining 82 patients,28 died and 54 survived.The proportion of poorly differentiated tumors,Child-Pugh grade B and distant metastasis in the deceased group were higher than those in the surviving group(P<0.05).The serum CEA levels in the deceased group were higher than that in the surviving group(P<0.05).The ALT/AST ratio in the deceased group was lower than that in the surviving group(P<0.05).Distant metastasis,ALT/AST,and CEA were independent risk factors for mortality(OR=4.158,4.039,and 4.067,respectively,P<0.05).The specificity and area under the curve(AUC)for predicting postoperative mortality in HCC patients using serum ALT/AST combined with CEA were 96.30%and 0.946,respectively,indicating higher predictive value than using ALT/AST or CEA alone.【Conclusion】Clinical detection of serum ALT/AST and CEA can serve as sensitive indicators for predicting postoperative mortality in HCC patients,with combined detection offering higher predictive value.
作者
李海林
刘东
唐金玉
LI Hailin;LIU Dong;TANG Jinyu(Department of Laboratory Medicine,Yangsi Hospital of Shanghai,Shanghai 200126)
出处
《医学临床研究》
CAS
2024年第6期900-902,906,共4页
Journal of Clinical Research
