1.Function of AFP and DCP in evaluating the prognosis of hepatocarcinoma
Jijun CHEN ; Hongxun YANG ; Chao LI ; Binggang ZHAO ; Qiang HAN ; Peng ZHAO ; Wen YIN
International Journal of Surgery 2013;(4):233-237
Objective To evaluate the prognosis in patients with hepatocarcinoma by examining the expression of α-fetoprotein (AFP) and des γ prothrombin (DCP).Methods Retrospectively analyzed the expression of AFP and DCP in 105 patients received curative hepatectomy.Divided the patients into three groups as follow:the tumor markers were both negative pre-and post-operation (Group N) ; the tumor markers decreased to normal after operation (Group D) ; the tumor markers kept positive or decreased but still higher positive after operation (Group P).Then combined the two markers and divided the patients into 4 groups:two markers both negative(AFP + DCP +)(Group A) ; AFP + DCP-(Group B) ; AFP-DCP + (Group C) ; AFP-DCP-(Group D).Results High AFP and DCP levels were significantly associated with poor tumor-free and overall survival.The presence of large size and advanced stage were significantly associated with Group P.Overall survival in the AFP-N group was significantly better than that of other groups and overall survival in DCP-N group were significantly better than that of the P group.After the combination,Group A had the best overall and tumor free survival rate while the D group had the worst.The differences between B and C group were not significant.Conclusions AFP and DCP can be both used solely as tumor markers and the expressions of them are associated with the prognosis.The combination of two markers can be used for better prediction of hepatocarcinoma.
2.Changes of thickness and area of ligamenta flavum after lateral lumbar interbody fusion
Hanming BIAN ; Wentao WAN ; Chao CHEN ; Xun SUN ; Dong ZHAO ; Haiyun YANG ; Binggang GUAN ; Qiang YANG
Chinese Journal of Orthopaedics 2023;43(8):500-507
Objective:To investigate the changes of thickness and area of the ligamentum flavum after lateral lumbar interbody fusion (LLIF) for lumbar degenerative diseases.Methods:From 2019 to 2021, a total of 54 patients with lumbar degenerative diseases who underwent LLIF combined with percutaneous pedicle screw internal fixation were retrospectively analyzed. There were 9 males and 45 females, aged 59.46±6.91 years (range, 45-76 years), followed up for 14.69±6.87 months (range, 12-33 months). The disc height (DH), midsagittal canal diameter (CD), dural sac axial cross-sectional area (DCSA), ligamentum flavum area (LFA) and ligamentum flavum thickness (LFT) before and after surgery and at the last follow-up were evaluated and compared. Pearson correlation analysis was used to assess the relationship between the amount of change in the DCSA and LFA in the immediate postoperative period and at the last follow-up, as well as the correlation between the two and the amount of change in the DH. The data of patients at the last follow-up of 12 months after operation were extracted. Pearson correlation was used to evaluate the changes in DCSA and LFA at the last follow-up and the visual analogue scale (VAS) of low back pain and leg pain and Oswestry disability index (ODI) at 1 year after surgery.Results:All patients were followed up for 14.69±6.87 months (range, 12-33 months). The differences in DH ( F=354.93, P<0.001), sagittal CD ( F=44.78, P<0.001) and DCSA ( F=130.97, P<0.001) before, immediately after surgery and at the last follow-up were statistically significant. The DH, sagittal CD, and DCSA immediate after surgery and last follow-up were higher than those before surgery ( P<0.05). The differences in LFA ( F=51.59, P<0.001) and bilateral LFT ( F=53.49, P<0.001; F=50.53, P<0.001) before and after surgery and at the last follow-up were statistically significant, and both LFA and bilateral LFT at immediate after surgery and last follow-up were smaller than those before surgery ( P<0.05). Pearson correlation analysis showed that the change of DH immediately after surgery was moderately correlated with the change of DCSA ( r=0.57, P<0.001), and was strongly correlated with the change of LFA ( r=0.65, P<0.001). The change of DH at the last follow-up was moderately correlated with the change of DCSA ( r=0.43, P<0.001), and was weakly correlated with the change of LFA ( r=0.25, P=0.042). The differences in VAS-leg ( F=199.51, P<0.001), VAS-low back ( F=233.90, P<0.001), and ODI ( F=199.17, P<0.001) were statistically significant in patients before operation, 3 months after operation and 12 months after operation. There was no correlation between the changes of DCSA and LFA at the last follow-up and the changes of VAS and ODI at 1 year after operation ( P>0.05). Conclusion:LFA and LFT decrease and DCSA increase in patients with lumbar degenerative diseases after LLIF. LFA and LFT gradually decrease with time, and VAS and ODI are significantly improved compared with those before surgery. The DH loss caused by a certain degree of cage subsidence after surgery does not affect the clinical efficacy. There is no correlation between the improvement of DCSA and LFA and the improvement of clinical symptoms.