血清组织多肽特异性抗原作为肝细胞癌根治性切除术后早期复发的无创性预后指标。

Serum tissue polypeptide specific antigen as a noninvasive prognostic indicator for early recurrence of hepatocellular carcinoma after curative resection.

作者信息

Yao Wei-Jen, Wang Shan-Tair, Chow Nan-Haw, Chang Ting-Tsung, Lin Pin-Wen, Tu Dom-Gene

机构信息

Department of Nuclear Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.

出版信息

Cancer. 2002 Jul 1;95(1):112-8. doi: 10.1002/cncr.10626.

DOI:10.1002/cncr.10626

PMID:12115324

Abstract

BACKGROUND

Serum tissue polypeptide specific antigen (TPS) is a useful cell proliferation marker in diagnosing and monitoring patients with a variety of malignancies. The objective of this study was to determine the usefulness of serum TPS as a noninvasive prognostic factor for early recurrence of hepatocellular carcinoma (HCC) after patients undergo curative resection.

METHODS

Serum TPS levels were measured by monoclonal TPS immunoradiometric assay in 54 patients shortly before they underwent curative resection for HCC. The recurrence time was correlated with the TPS level and with other prognostic factors using the log-rank test in univariate analysis and a Cox regression in multivariate analysis. Receiver operating characteristic analysis was performed to examine the power of the various prognostic factors to distinguish between patients with recurrent tumors and patients who were disease free.

RESULTS

Patients who had higher levels of TPS (>or= 150 U/L) had earlier recurrences compared with patients who had lower levels of TPS (< 150 U/L; P = 0.016) in univariate analysis. Tumor size, the number of tumors, portal vein invasion, and the resection margins also were associated significantly with the time to tumor recurrence (P = 0.015, P = 0.004, P = 0.003, and P = 0.003, respectively). Serum alpha-fetoprotein was not a significant risk factor for tumor recurrence. In multivariate analysis, the TPS level, tumor size, and resection margins were independent prognostic factors (P = 0.025, P = 0.018, and P = 0.016, respectively). The inclusion of TPS in addition to tumor size and resection margins increased the rate of corrective prediction from 0.72 to 0.80.

CONCLUSIONS

The current study demonstrated that the preoperative serum TPS level was a significant factor in predicting early recurrence of HCC after curative resection. Patients with high serum TPS levels warrant more aggressive treatment and close follow-up after they undergo tumor resection.

摘要

背景

血清组织多肽特异性抗原（TPS）是诊断和监测多种恶性肿瘤患者的一种有用的细胞增殖标志物。本研究的目的是确定血清TPS作为肝细胞癌（HCC）患者根治性切除术后早期复发的非侵入性预后因素的有效性。

方法

采用单克隆TPS免疫放射分析法，在54例即将接受HCC根治性切除的患者术前不久测定血清TPS水平。在单因素分析中，使用对数秩检验，在多因素分析中使用Cox回归，将复发时间与TPS水平及其他预后因素进行相关性分析。进行受试者工作特征分析，以检验各种预后因素区分复发肿瘤患者和无疾病患者的能力。

结果

在单因素分析中，TPS水平较高（≥150 U/L）的患者比TPS水平较低（<150 U/L）的患者复发更早（P = 0.016）。肿瘤大小、肿瘤数量、门静脉侵犯和切缘也与肿瘤复发时间显著相关（分别为P = 0.015、P = 0.004、P = 0.003和P = 0.003）。血清甲胎蛋白不是肿瘤复发的显著危险因素。在多因素分析中，TPS水平、肿瘤大小和切缘是独立的预后因素（分别为P = 0.025、P = 0.018和P = 0.016）。除肿瘤大小和切缘外纳入TPS，将校正预测率从0.72提高到0.80。