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术前甲胎蛋白和脱γ-羧基凝血酶原联合检测预测乙型肝炎相关肝细胞癌患者根治性切除术后复发。

Combined measurement of preoperative α-fetoprotein and des-γ-carboxy prothrombin predicts recurrence after curative resection in patients with hepatitis-B-related hepatocellular carcinoma.

机构信息

Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.

出版信息

Int J Cancer. 2012 Nov 15;131(10):2332-41. doi: 10.1002/ijc.27507. Epub 2012 Mar 28.


DOI:10.1002/ijc.27507
PMID:22362471
Abstract

Alpha-fetoprotein (AFP) and des-γ-carboxy prothrombin (DCP) are widely used complementary tumor markers for hepatocellular carcinoma (HCC). In this study, we investigated whether preoperative AFP and DCP levels predict recurrence after curative resection in patients with hepatitis B virus (HBV)-related HCC. Records for 267 patients who were diagnosed with HBV-related HCC and who underwent curative resection for HCC were retrospectively reviewed. Patients were divided into two preoperative groups: pre-op I (AFP ≥ 20 ng/dL and DCP ≥ 40 mAU/mL) and pre-op II (AFP ≥ 20 ng/dL and DCP <40 mAU/mL; AFP <20 ng/dL and DCP ≥ 40 mAU/mL; or AFP <20 ng/dL and DCP <40 mAU/mL). Among 267 patients, 102 (38.2%) patients were classified as pre-op I, whereas the other 165 (61.8%) belonged to pre-op II. During the post-resection follow-up [69.0 (3.0-136.0) months] period, 154 (57.7%) patients developed recurrences [68 (66.7%) patients in pre-op I vs. 86 (52.1%) in pre-op II, p = 0.029]. A multivariate analysis revealed that multiple tumors [hazard ratio (HR), 2.210; 95% confidence interval (CI), 1.185-4.121] and pre-op I (HR: 1.890; 95% CI; 1.080-3.289) were significant predictors for recurrence. Disease-free survival (DFS) was significantly shorter in pre-op I compared to that in pre-op II (20.0 vs. 46.8 months, p = 0.006). Elevated preoperative AFP and DCP levels were associated with a higher recurrence rate and shorter DFS in patients with HBV-related HCC after curative resection. The combined measurement of preoperative AFP and DCP may be a prognostic factor for future recurrence.

摘要

甲胎蛋白(AFP)和脱-γ-羧基凝血酶原(DCP)是广泛用于肝细胞癌(HCC)的互补肿瘤标志物。在这项研究中,我们研究了术前 AFP 和 DCP 水平是否可以预测乙型肝炎病毒(HBV)相关 HCC 患者根治性切除术后的复发。回顾性分析了 267 例诊断为 HBV 相关 HCC 并接受 HCC 根治性切除术的患者的记录。患者分为术前两组:术前 I 组(AFP≥20ng/dL 和 DCP≥40mAU/mL)和术前 II 组(AFP≥20ng/dL 和 DCP<40mAU/mL;AFP<20ng/dL 和 DCP≥40mAU/mL;或 AFP<20ng/dL 和 DCP<40mAU/mL)。在 267 例患者中,102 例(38.2%)患者被归类为术前 I 组,而其余 165 例(61.8%)属于术前 II 组。在术后随访期间[69.0(3.0-136.0)个月],154 例(57.7%)患者发生复发[术前 I 组 68 例(66.7%),术前 II 组 86 例(52.1%),p=0.029]。多因素分析显示,多发病灶[风险比(HR),2.210;95%置信区间(CI),1.185-4.121]和术前 I 组(HR:1.890;95%CI;1.080-3.289)是复发的显著预测因子。与术前 II 组相比,术前 I 组的无病生存率(DFS)明显更短(20.0 与 46.8 个月,p=0.006)。HBV 相关 HCC 患者根治性切除术后,术前 AFP 和 DCP 水平升高与复发率升高和 DFS 缩短相关。术前 AFP 和 DCP 的联合检测可能是预测复发的预后因素。

相似文献

[1]
Combined measurement of preoperative α-fetoprotein and des-γ-carboxy prothrombin predicts recurrence after curative resection in patients with hepatitis-B-related hepatocellular carcinoma.

Int J Cancer. 2012-3-28

[2]
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[3]
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[4]
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[5]
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[6]
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[7]
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[8]
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[9]
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[10]
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引用本文的文献

[1]
Tumor burden score combined with AFP and PIVKA-II (TAP score) to predict the prognosis of hepatocellular carcinoma patients after radical liver resection.

Langenbecks Arch Surg. 2025-3-6

[2]
Prognostic model for predicting recurrence in hepatocellular carcinoma patients with high systemic immune-inflammation index based on machine learning in a multicenter study.

Front Immunol. 2024

[3]
Preoperative Prediction of Microvascular Invasion with Gadoxetic Acid-Enhanced Magnetic Resonance Imaging in Patients with Single Hepatocellular Carcinoma: The Implication of Surgical Decision on the Extent of Liver Resection.

Liver Cancer. 2023-7-7

[4]
The role of alpha-fetoprotein in the tumor microenvironment of hepatocellular carcinoma.

Front Oncol. 2024-4-10

[5]
Levels of PIVKA-II and alpha-fetoprotein in unresectable hepatocellular carcinoma compared to healthy controls and predictive values of both markers with radiological responses after loco-regional interventions.

PeerJ. 2023

[6]
Longitudinal surveillance of three biomarkers to predict recurrence of hepatocellular carcinoma after radical resection.

Eur J Gastroenterol Hepatol. 2023-10-1

[7]
Perioperative predictors of outcome of hepatectomy for HBV-related hepatocellular carcinoma.

Front Oncol. 2023-7-13

[8]
Usefulness of PIVKA-II for monitoring after liver transplantation in patients with hepatocellular carcinoma.

Sci Rep. 2023-4-6

[9]
Short Half-Life of Des-γ-Carboxy Prothrombin Is a Superior Factor for Early Prediction of Outcomes of Hepatocellular Carcinoma Treated with Radiofrequency Ablation.

Diagnostics (Basel). 2023-2-12

[10]
Utility of combining PIVKA-II and AFP in the surveillance and monitoring of hepatocellular carcinoma in the Asia-Pacific region.

Clin Mol Hepatol. 2023-4

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