Liver Cancer Institute and Zhongshan Hospital, Fudan University, Shanghai, China.
Ann Surg Oncol. 2013 Mar;20(3):929-37. doi: 10.1245/s10434-012-2749-9. Epub 2012 Dec 1.
Presurgery serum osteopontin (OPN) level has been demonstrated to correlate to tumor recurrence and survival of hepatocellular carcinoma (HCC) patients. This study investigated the postoperative dynamic changes of serum OPN level and its clinical significance in HCC patients.
Presurgery serum OPN levels were measured by enzyme-linked immunosorbent assay in cohort A of 179 HCC patients and were compared with the multiple controls including different kinds of liver diseases and healthy individuals. In cohort B of 110 patients with resectable HCCs, besides preoperative assays, serum OPN was monitored at 1 week, 1, and ≥2 months after operation.
The baseline presurgery serum OPN of HCC patients was significantly higher than that of the patients with the other kinds of liver diseases (p < 0.0001). The prognostic values of presurgery serum OPN level in HCC patients were further confirmed. The postsurgery OPN levels were significantly elevated within 1 week after HCC resection, then decreased at 1 month and reached the nadir later than 2 months after operations. It increased again at the time of tumor recurrence, then declined after the second removal of recurrent HCCs. Moreover, postoperative OPN in α-fetoprotein-negative and -positive HCC patients had the same changing pattern; it only correlated to liver function and C-reactive protein level.
After a transient fluctuation, serum OPN levels significantly decrease after curative resection of HCCs. Postoperative serum OPN could serve as a surrogate serologic biomarker for monitoring treatment response and tumor recurrence after HCC resection, including α-fetoprotein-negative ones.
术前血清骨桥蛋白（OPN）水平与肝癌（HCC）患者的肿瘤复发和生存相关。本研究探讨了 HCC 患者术后血清 OPN 水平的动态变化及其临床意义。
在队列 A 中，对 179 例 HCC 患者进行了术前血清 OPN 水平的酶联免疫吸附试验检测，并与不同类型的肝病和健康个体的多种对照进行了比较。在可切除 HCC 患者的队列 B 中，除了术前检测外，还在术后 1 周、1 个月和≥2 个月监测血清 OPN。
HCC 患者的基线术前血清 OPN 明显高于其他类型肝病患者（p<0.0001）。术前血清 OPN 水平在 HCC 患者中的预后价值得到进一步证实。HCC 切除术后，术后 OPN 水平在 1 周内显著升高，然后在 1 个月时降低，晚于 2 个月达到最低点。在肿瘤复发时再次升高，然后在第二次切除复发性 HCC 后下降。此外，α-胎蛋白阴性和阳性 HCC 患者的术后 OPN 具有相同的变化模式；它仅与肝功能和 C-反应蛋白水平相关。
在 HCC 根治性切除后，血清 OPN 水平会出现短暂波动，然后显著下降。术后血清 OPN 可作为监测 HCC 切除后治疗反应和肿瘤复发的替代血清生物标志物，包括α-胎蛋白阴性 HCC。
