Kitai Satoshi, Kudo Masatoshi, Minami Yasunori, Haji Seiji, Osaki Yukio, Oka Hiroko, Seki Toshihito, Kasugai Hiroshi, Sasaki Yo, Matsunaga Takashi
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kinki University School of Medicine, Osaka, Japan.
Oncology. 2008;75 Suppl 1:83-90. doi: 10.1159/000173428. Epub 2008 Dec 17.
The conventional Japan Integrated Staging (c-JIS) score has been reported to effectively stratify patients with hepatocellular carcinoma (HCC). Recently, two new staging systems, the biomarker-combined JIS (bm-JIS) score and the BALAD score, have been proposed. Both staging systems include three tumor markers: alpha-fetoprotein (AFP), lens culinaris agglutinin-reactive AFP and des-gamma-carboxy prothrombin specific for HCC. The aim of this study is to evaluate the performance of these three staging systems.
A total of 1,173 HCC patients were included in this study. The stratification ability and prognostic predictive power were compared between these three staging systems.
These three staging systems effectively predicted the patient survival. When accounting for the best prognostic subgroup of each staging systems (i.e. score of 0), there were significant differences between the bm-JIS score and the BALAD score and, likewise, between the c-JIS score and the BALAD score. The likelihood ratio chi(2) test showed the highest value and the Akaike information criterion value was lowest in the bm-JIS score.
The bm-JIS score showed good stratification ability and was thus demonstrated to be a better predictor of the prognosis than the c-JIS score and the BALAD score, especially for the patients with a good prognosis.
据报道，传统的日本综合分期（c-JIS）评分可有效对肝细胞癌（HCC）患者进行分层。最近，提出了两种新的分期系统，即生物标志物联合JIS（bm-JIS）评分和BALAD评分。这两种分期系统均包括三种肿瘤标志物：甲胎蛋白（AFP）、豆凝集素反应性AFP和肝癌特异性去γ-羧基凝血酶原。本研究的目的是评估这三种分期系统的性能。
本研究共纳入1173例HCC患者。比较这三种分期系统之间的分层能力和预后预测能力。
这三种分期系统均能有效预测患者生存。考虑到各分期系统的最佳预后亚组（即评分为0）时，bm-JIS评分与BALAD评分之间存在显著差异，同样，c-JIS评分与BALAD评分之间也存在显著差异。似然比χ2检验显示bm-JIS评分的值最高，赤池信息准则值最低。
bm-JIS评分显示出良好的分层能力，因此被证明是比c-JIS评分和BALAD评分更好的预后预测指标，尤其是对于预后良好的患者。
