The Analysis Of Clinical And Pathology Characteristics And Prognosis Of Early-mid-stage Hepatocellular Carcinoma With Different AFP Secretion Status

Objective:To analyze the clinical and pathological characteristics and prognosis of early-mid-stage hepatocellular carcinoma with different AFP secretion status,and to guide the clinical treatment and the prognosis judgment.Methods:We choose 137 patients with early-mid-stage HCC among the 1600 PLC patients admitted to Zhongda Hospital from August 2013 to December 2019 through strict inclusion and exclusion criteria.According to the AFP levels before treatment,the patients were divided into the following three groups: AFP negative group,(AFP≤20ng / m L,58 cases);AFP positive group(20ng / m L <AFP <400ng / m L,49 cases);AFP strong positive group(AFP≥400ng / m L,30 cases).Chi-square test or Fishers exact test were used to compare the differences of clinical and pathological date in three groups.Kaplane-Meier method was used for survival analysis.log-rank test was used for univariate analysis,and Cox regression was used for multivariate analysis to explore the relevant factors affecting prognosis.Results:1.The average age of the AFP strong positive group(55.73 ± 9.727 years)was younger than the negative group(61.5 ± 9.083 years),and the positive group(62.06 ±10.085 years)(P <0.05);There was no statistically significant difference in average age between AFP negative group and positive group(P > 0.05);2.The CA199 positive rate(12.1%)in the AFP negative group was 20.6% lower than the positive group(32.7%)(P <0.05);There was no statistically significant difference in the positive rate of CA199 between the AFP negative group and the strong positive group,as well as between the positive group and the strong positive group(P>0.05);3.The positive rate of Anti-HCV in the positive group was 36.7%,which was higher than the other two groups(P <0.05);The difference between the AFP negative group and the strong positive group was not statistically significant(P> 0.05);4.The proportion of TNM stage III in the AFP strong positive group(36.7%)was higher than the other two groups(P <0.05);There was no statistically significant difference between the AFP negative group and the positive group(P> 0.05);5.The proportion of tumor‘s diameter ≥10cm(36.7%)in the AFP strong positive group was higher than the other two groups(P <0.05);the difference between the AFP negative group and the positive group was not statistically significant(P> 0.05);6.The proportion of low differentiation(36.7%)in the AFP strong positive group was higher than the other two groups(P <0.05);The difference between the AFP negative group and the positive group was not statistically significant(P> 0.05);7.The positive rate of CD34(82.8%)in the AFP negative group was higher than the other two groups(P <0.05);There was no statistically significant difference between the positive group and the strong positive group(P> 0.05);8.The 1,3,5 years recurrence-free survival rates of the AFP negative group were74.1%,48.2%,and 25.0%,and the 1,3,5 years recurrence-free survival rates of the AFP positive group were 53.1%,30.6%,and 10.9%.The1,3,5 years recurrence-free survival rates of the AFP strong positive group were 45.4%,21.0%,and 7.0%.and the difference between the negative and positive group was statistically significant(P<0.05);The difference between the remaining groups was not statistically significant(P> 0.05);9.Univariate analysis showed that gender,age,and pathological classification were the main risk factors affecting the prognosis of patients with early-mid-stage HCC.Multivariate analysis showed that age,TNM stage,and treatment methods were independent risk factors that affected the prognosis.Conclusion:1.AFP is negatively correlated with age,pathological differentiation and CD34,positively correlated with CA199,Anti-HCV,TNM staging and tumor size.There was no significant correlation between AFP and gender,CEA,HBs Ag,HBV-DNA,cirrhosis and Child-Pugh classification,BCLC stage,treatment,tumor number,pathological classification,and vascular tumor thrombus infiltration.2.Survival analysis showed that the relapse-free survival time was longer in the AFP negative group.3.Gender,age,and pathological classification are the main risk factors affecting the prognosis of patients with early-mid-stage HCC,while age,TNM stage,and treatment are independent risk factors that affect the prognosis.