Second Department of Surgery, Wakayama Medical University, School of Medicine, Wakayama, Japan.
Ann Surg. 2011 Dec;254(6):984-91. doi: 10.1097/SLA.0b013e3182215016.
To determine the importance of the expression pattern of multiple tumor markers for hepatocellular carcinoma (HCC) with regard to the tumor malignancy and patient survival.
Several studies have indicated that HCC tumor markers, including alpha-fetoprotein (AFP), Lens culinaris agglutinin-reactive fraction of AFP and des-γ-carboxy prothrombin were predictors of HCC malignancy. However, few reports have shown the relevance of the expression pattern of these 3 tumor markers with regard to patient prognosis. We herein reported the influence of the expression pattern of these 3 tumor markers on HCC malignancy and patient prognosis.
This retrospective study analyzed 185 patients who underwent hepatectomy for HCC between January 1999 and May 2009. The relationships between clinical parameters and these 3 tumor markers were analyzed. Cox proportional hazards regression analyses were performed to estimate risk factors for recurrence and survival. Furthermore, the relationships between pathological parameters and the expression patterns of the 3 tumor markers were analyzed.
From clinical parameters, expression patterns of 3 tumor markers were related to maximum tumor size and macrovascular invasion in image findings. Multivariate analyses revealed independent risk factors for recurrence or survival to be the Child-Pugh score, the presence of multiple tumors, and triple positive tumor marker expression. From pathological findings, microvascular invasion and an Edmondson-Steiner classification of III or IV were related to the expression patterns of the 3 tumor markers.
Triple positive tumor markers for HCC showed poor prognosis and invasive characteristics in pathological findings. Examination of these markers would be useful for predicting the degree of HCC malignancy.
确定多种肿瘤标志物在肝癌（HCC）表达模式的重要性，特别是在肿瘤恶性程度和患者生存方面。
多项研究表明，HCC 肿瘤标志物，包括甲胎蛋白（AFP）、扁豆凝集素结合 AFP 反应片段和去γ-羧基凝血酶原，是 HCC 恶性程度的预测因子。然而，很少有报道表明这 3 种肿瘤标志物表达模式与患者预后的相关性。我们在此报告了这 3 种肿瘤标志物表达模式对 HCC 恶性程度和患者预后的影响。
本回顾性研究分析了 1999 年 1 月至 2009 年 5 月期间接受肝切除术治疗 HCC 的 185 例患者。分析了临床参数与这 3 种肿瘤标志物之间的关系。采用 Cox 比例风险回归分析来估计复发和生存的风险因素。此外，还分析了病理参数与 3 种肿瘤标志物表达模式之间的关系。
从临床参数来看，3 种肿瘤标志物的表达模式与影像学检查中的最大肿瘤直径和大血管侵犯有关。多因素分析显示，复发或生存的独立风险因素为 Child-Pugh 评分、多发肿瘤和 3 种肿瘤标志物均阳性。从病理发现来看，微血管侵犯和 Edmondson-Steiner 分级为 III 或 IV 级与 3 种肿瘤标志物的表达模式有关。
HCC 的 3 种肿瘤标志物均阳性提示预后不良，且具有侵袭性病理特征。这些标志物的检测有助于预测 HCC 的恶性程度。
