Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Int J Cancer. 2012 Nov 15;131(10):2332-41. doi: 10.1002/ijc.27507. Epub 2012 Mar 28.
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.
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。
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