Relationship between serum alpha-fetoprotein level and clinical features of hepatoblastoma in children / 中华普通外科杂志

ABSTRACT

Objective To analyze the relationship between the clinical features of hepatoblastoma and serum alpha-fetoprotein level.Methods We did a retrospective study in 74 cases into the relationship of clinical stages,treatment,prognosis,and AFP value in hepatoblastoma.Results In Stage Ⅰ and Ⅱ patients,the average AFP was (36 333 ± 13 782) ng/ml and in Stage Ⅲ and Ⅳ,the average AFP was (78 346 ± 27 956) ng/ml,P ＜ 0.05.68 patients received preoperative chemotherapy with alpha-fetoprotein determinations before and after chemotherapy respectively.In 44 cases AFP decreased ＞ 50％ after chemotherapy,and in 20 cases AFP declined ＞90％,while in 13 cases AFP increased after chemotherapy.15 cases had serum AFP measured on the first postoperative day,among them 10 cases had a ＞ 50％ AFP decline,3 cases had a ＜ 50％ AFP decline,while in 2 cases AFP value increased.52 cases were postoperatively followed-up,with overall 3 year-survival rate of 86.5％ ; 7 cases recurred,4 died.The average preop AFP level in 7 recurred cases was (27 060 ± 3 569) ng/ml,while the average preop AFP level in those of 3-year recurrence-free was (29 865 ± 5 867) ng/ml,P ＞ 0.05.Only 57％ tumor recurred cases had back to normal AFP level within one month postop,while 89％ long term survivals reported normal range of AFP during that period,P ＜ 0.05.Conclusions Serum AFP level in patients with hepatoblastoma is related to the course of disease.It can be used to estimate the effect of clinical chemotherapy.The speed of alpha-fetoprotein decline postop can be used as an indicator of prognosis.The postoperative normal AFP level within 4 weeks predicts a favorable prognosis.