Clinical And Pathology Analysis Of Hepatocellular Carcinoma With Negative Alpha-fetoprotein

Objective To analyze clinical and pathology characteristics of hepatocellular carcinoma(HCC)patients with negative alpha-fetoprotein(AFP),and to evaluate the factors which influence prognosis.Methods To collect the data of patients with AFP-negative HCC treated by Hepatectomy in General Hospital of Ningxia Medical University from January 2010 to January 2016.According to the level of preoperative AFP,the subjects were divided into two groups,AFP-negative group and AFP-positive group.To compare two groups in general information,preoperative examination data,hepatitis B background,intraoperative condition,and postoperative pathology.Two groups were followed up to compare the differences of survival rates in 1-year,3-year and 5-year,and to analyze the factors that influence prognosis of AFP-negative group.Result There were no significant difference between the AFP-negative hepatocellular carcinoma and AFP-positive hepatocellular carcinoma in sex,age,ethnicity,hospitalization time,clinical symptoms,ALT,AST,GGT,HBV-DNA,intraoperative blood loss,satellite lesions,capsule and postoperative complications(P>0.05).Two groups were significantly different in HbsAg,cirrhosis,tumor size,tumor embolus and tumor histopathological grading(P <0.05).The cumulative survival rate of 1,3,5-year in overall were 77%,62%,48%.The cumulative survival rate of 1,3,5-year in AFP-negative group were 93%,78%,67%;the cumulative survival rate of 1,3,5-year in AFP-positive group were 69%,54%,39%.Univariate analysis show the cumulative survival rate of 1,3,5-year in AFP negative HCC were higher than in AFP positive HCC(P=0.002).Univariate analysis indicated tumor embolus and tumor histopathological grading were related to the cumulative survival of AFP-negative group.Multivariable analysis illustrated tumor embolus or tumor histopathological grading was not an independent risk factor for AFP-negative hepatocellular carcinoma(P>0.05).Conclusion 1.Preoperative alpha-fetoprotein levels was not correlated with sex,age,ethnicity,hospitalization time,clinical symptoms,ALT,AST,GGT,HBV-DNA,satellite lesions,and envelope.2.Preoperative alpha-fetoprotein levels was correlated with HbsAg,cirrhosis,tumor size,tumor embolus and tumor histopathological grading.3.AFP-negative HCC patients had a better prognosis than AFP-positive HCC patients.