Eastern Hepatobiliary Surgery Hospital, The Second Military Medical University, Shanghai, China.
1] Eastern Hepatobiliary Surgery Hospital, The Second Military Medical University, Shanghai, China [2] Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.
Br J Cancer. 2014 Apr 2;110(7):1811-9. doi: 10.1038/bjc.2014.102. Epub 2014 Feb 25.
Preoperative alpha-L-fucosidase (AFU) has been used as a diagnostic biomarker for hepatocellular carcinoma (HCC), but its role as a prognostic predictor after partial hepatectomy has not been well defined. The study aimed to investigate the prognostic significance of preoperative serum AFU for HCC patients after hepatic resection.
A retrospective training data set and a prospective validation data set were used to evaluate the prognosis of HCC after partial hepatectomy. A total of 669 patients with histopathologically confirmed HCC were enrolled. Univariate and multivariate analyses were used to identify the prognostic significance of preoperative serum AFU.
The retrospective training data set showed a preoperative AFU>35 u l(-1) should be used. The prospective validation data set showed preoperative AFU was an independent prognostic factor of overall survival (OS) (P=0.008; hazard ratio: 2.333; 95% confidence interval: 1.249-4.369). Patients with a preoperative AFU>35 u l(-1) had a lower recurrence-free survival rate and an OS rate than those with AFU≤35 u l(-1), and they have a higher tendency to form macrovascular invasion. Furthermore, the prognostic significance of AFU>35 u l(-1) could also be applied to patients with alpha-fetoprotein levels of ≤400 ng ml(-1).
Preoperative serum AFU is a prognostic predictor of HCC.
术前α-L-岩藻糖苷酶（AFU）已被用作肝细胞癌（HCC）的诊断生物标志物，但它在肝部分切除术后作为预后预测因子的作用尚未得到很好的定义。本研究旨在探讨术前血清 AFU 对 HCC 患者肝切除术后的预后意义。
使用回顾性训练数据集和前瞻性验证数据集来评估 HCC 患者肝部分切除术后的预后。共纳入 669 例经组织病理学证实的 HCC 患者。采用单因素和多因素分析确定术前血清 AFU 的预后意义。
回顾性训练数据集显示术前 AFU>35u/l(-1) 应作为截断值。前瞻性验证数据集显示，术前 AFU 是总生存期（OS）的独立预后因素（P=0.008；风险比：2.333；95%置信区间：1.249-4.369）。术前 AFU>35u/l(-1)的患者无复发生存率和 OS 率均低于 AFU≤35u/l(-1)的患者，且更倾向于形成大血管侵犯。此外，AFU>35u/l(-1)的预后意义也适用于甲胎蛋白水平≤400ng/ml(-1)的患者。
术前血清 AFU 是 HCC 的预后预测因子。
