Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
J Surg Oncol. 2010 Oct 1;102(5):490-6. doi: 10.1002/jso.21451.
It is important to identify prognostic factors in patients with hepatocellular carcinoma (HCC) before hepatectomy. No previous studies have addressed the predictive efficacy of the preoperative doubling times of alpha-fetoprotein (AFP) and protein induced by vitamin K absence (PIVKA-II).
A total of 210 HCC patients who underwent a hepatic resection between 1998 and 2006 were prospectively evaluated. Serum AFP and PIVKA-II levels were measured at least twice before surgery to calculate the doubling times. Nineteen clinical factors that can be examined preoperatively, including the doubling times of AFP and PIVKA-II were investigated to identify prognostic factors for disease-free and overall survival after hepatectomy.
There was no relationship between preoperative levels and doubling times of AFP and PIVKA-II. In a multivariate analysis, patients with a doubling time of AFP ≤30 days and PIVKA-II ≤16 days showed a significantly worse disease-free (P = 0.02, P = 0.03, respectively) and overall survival (P < 0.0001, P = 0.03, respectively).
In HCC patients, the doubling times of preoperative serum AFP or PIVKA-II levels are useful tools to predict early postoperative recurrence and a poor prognosis.
在肝癌（HCC）患者行肝切除术前识别预后因素非常重要。既往研究尚未探讨甲胎蛋白（AFP）和维生素 K 缺乏诱导蛋白（PIVKA-II）术前倍增时间的预测效果。
前瞻性评估了 1998 年至 2006 年间行肝切除术的 210 例 HCC 患者。至少在术前两次测量血清 AFP 和 PIVKA-II 水平，以计算倍增时间。研究了 19 种术前可检查的临床因素，包括 AFP 和 PIVKA-II 的倍增时间，以确定术后无病和总生存的预后因素。
术前 AFP 和 PIVKA-II 的水平与倍增时间之间无相关性。多因素分析显示，AFP 倍增时间≤30 天和 PIVKA-II 倍增时间≤16 天的患者无病生存（P=0.02，P=0.03）和总生存（P<0.0001，P=0.03）明显较差。
在 HCC 患者中，术前血清 AFP 或 PIVKA-II 水平的倍增时间是预测术后早期复发和预后不良的有用工具。
