The Predictive Value of Serum Alanine Aminotransferase/Aspartate Aminotransferase Combined with Carcinoembryonic Antigen for Postoperative Prognosis in Patients with Hepatocellular Carcinoma
LI Hailin, LIU Dong, TANG Jinyu
Department of Laboratory Medicine,Yangsi Hospital of Shanghai,Shanghai 200126
Abstract：【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.
李海林, 刘东, 唐金玉. 血清谷丙转氨酶/谷草转氨酶联合癌胚抗原预测肝细胞癌术后患者预后的价值[J]. 医学临床研究, 2024, 41(6): 900-902.
LI Hailin, LIU Dong, TANG Jinyu. The Predictive Value of Serum Alanine Aminotransferase/Aspartate Aminotransferase Combined with Carcinoembryonic Antigen for Postoperative Prognosis in Patients with Hepatocellular Carcinoma. JOURNAL OF CLINICAL RESEARCH, 2024, 41(6): 900-902.
[1] SAMANT H, AMIRI H S, ZIBARI G B. Addressing the worldwide hepatocellular carcinoma: epidemiology, prevention and management[J].J Gas Oncol,2021, 12(2):361-373. [2] TADA T, KUMADA T, HIRAOKA A, et al. Safety and efficacy of atezolizumab plus bevacizumab in elderly patients with hepatocellular carcinoma: a multicenter analysis [J].Cancer Med,2022, 11(20):3796-3808. [3] HUANG A, YANG X R, CHUNG W Y, et al. Targeted therapy for hepatocellular carcinoma [J].Signal Transduct Target Ther,2020, 5(1):146-157. [4] WU T C, SHEN Y C, CHENG A L. Evolution of systemic treatment for advanced hepatocellular carcinoma [J].Kaohsiung J Med Sci,2021, 37(8):643-653. [5] SONG B, ZHOU S, LI C, et al. A prediction model for chemotherapy-induced thrombocytopenia based on real-world data and a close relationship between AST/ALT ratio and platelet count in patients with solid tumors[J].Int J Gen Med,2022, 15(3):8003-8015. [6] 张程程,费素娟.血清胱抑素C、癌胚抗原、抗原199联合检测在结直肠癌诊断中的价值研究[J].安徽医药,2022,26(10):2038-2041. [7] 陶一明,王志明. 欧洲肝脏研究学会肝细胞癌临床实践指南(2018)更新要点解读[J].中国普通外科杂志,2018,27(7):813-817. [8] GAO X, ZHAO C, ZHANG N, et al. Genetic expression and mutational profile analysis in different pathologic stages of hepatocellular carcinoma patients [J].BMC Cancer,2021, 21(1):786-795. [9] PANDYARAJAN V, GOVALAN R, YANG J D. Risk factors and biomarkers for chronic hepatitis B associated hepatocellular carcinoma [J].Int J Mol Sci,2021, 22(2):479-487. [10] 辛海光,谢青.抗病毒治疗时代慢性乙型肝炎患者发生肝细胞癌的风险评估及管理[J].中华肝脏病杂志,2021,29(4):297-300. [11] ALJOBAILY N, VIERECKL M J, HYDOCK D S, et al. Creatine alleviates doxorubicin-induced liver damage by inhibiting liver fibrosis, inflammation, oxidative stress, and cellular senescence [J].Nutrients,2020, 13(1):41-48. [12] 陈港心,杜嘉原,汪富涛,等.胃癌根治术治疗患者血清ALB、AFP水平及LSR在预后评估中的价值[J].检验医学与临床,2021,18(24):3571-3574. [13] CHEN W, WANG W, ZHOU L, et al. Elevated AST/ALT ratio is associated with all-cause mortality and cancer incident [J].J Clin Lab Anal,2022, 36(5):356-364. [14] ZHANG L X, LV Y, XU A M, et al. The prognostic significance of serum gamma-glutamyltransferase levels and AST/ALT in primary hepatic carcinoma [J].BMC Cancer,2019, 19(1):841-849. [15] LUO P Q, YE Z H, ZHANG L X, et al.Prognostic factors for disease-free survival in postoperative patients with hepatocellular carcinoma and construction of a nomogram model[J].World J Clin Cases,2022,10(36):13250-13263.
2024, Vol. 41 
