Zhou Yan, Ma Xiaolu, Wu Jiong, Zhang Chunyan, Wang Beili, Song Binbin, Guo Wei, Pan Baishen
Department of Laboratory Medicine,Zhongshan Hospital, Fudan University, Shanghai 200032, China.
Department of Laboratory Medicine,Zhongshan Hospital, Fudan University, Shanghai 200032, China. Email:
Zhonghua Yi Xue Za Zhi. 2014 Dec 16;94(46):3623-8.
To investigate the early-recurrence prediction value of preoperative alpha-1-fucosidase (AFU) for hepatocellular carcinoma (HCC) patients undergoing curative resection.
A retrospective training set data from January to July, 2012 including 116 patients and a prospective validation set from August 2012 to December 2012 including 68 patients were used to validate the predictive value of preoperative AFU. Difference of recurrence rates between low and high AFU populations in all HCC or early-HCC subgroups were compared via Kaplan-Meier curves and Log-rank tests. Univariate and multivariate analyses were used to identify the recurrent prediction value of preoperative serum AFU.
Based on retrospective training data, AFU = 25.00 U/L was set as the optimal cutoff point to stratify HCC patients into high (>25.00 U/L) and low ( ≤ 25.00 U/L) groups. Patients with high preoperative AFU showed significant low tumor-free survival not only in whole patients group (mean 12.50 months vs.not reached; P < 0.01) but also in early-HCC (mean 10.25 months vs.not reached, P < 0.01) and AFP negative subgroups (mean 13.20 months vs not reached, P < 0.01). Univariate and multivariate analyses revealed the AFU was an independent predictor for tumor recurrence (OR = 1.72, 95%CI:1.00-2.96, P = 0.04). The prospective validation data confirmed the predictive value of preoperative AFU in HCC (OR = 2.22, 95%CI:0.67-7.37, P = 0.04). Furthermore, patients with high preoperative AFU were prone to have bigger tumor and form vascular invasion.
Preoperative AFU is a powerful prognostic indicator for HCC and 25.00 U/L might be an optimal recurrence prediction cutoff value for patients in Zhongshan hospital.
探讨术前α-1-岩藻糖苷酶（AFU）对接受根治性切除的肝细胞癌（HCC）患者早期复发的预测价值。
采用2012年1月至7月的回顾性训练集数据（包括116例患者）和2012年8月至12月的前瞻性验证集数据（包括68例患者）来验证术前AFU的预测价值。通过Kaplan-Meier曲线和对数秩检验比较所有HCC或早期HCC亚组中低AFU人群和高AFU人群的复发率差异。采用单因素和多因素分析来确定术前血清AFU的复发预测价值。
基于回顾性训练数据，将AFU = 25.00 U/L设定为将HCC患者分为高（>25.00 U/L）低（≤25.00 U/L）两组的最佳临界值。术前AFU高的患者不仅在全患者组中无瘤生存期显著缩短（平均12.50个月对未达到；P < 0.01），在早期HCC组（平均10.25个月对未达到，P < 0.01）和AFP阴性亚组（平均13.20个月对未达到，P < 0.01）中也是如此。单因素和多因素分析显示AFU是肿瘤复发的独立预测因素（OR = 1.72，95%CI：1.00 - 2.96，P = 0.04）。前瞻性验证数据证实了术前AFU在HCC中的预测价值（OR = 2.22，95%CI：0.67 - 7.37，P = 0.04）。此外，术前AFU高的患者倾向于有更大的肿瘤并形成血管侵犯。
术前AFU是HCC的有力预后指标，25.00 U/L可能是中山医院患者复发预测的最佳临界值。
