Nakagawa Shigeki, Hayashi Hiromitsu, Nitta Hidetoshi, Okabe Hirohisa, Sakamoto Keita, Higashi Takaaki, Kuroki Hideyuki, Imai Katsunori, Hashimoto Daisuke, Sakamoto Yasuo, Chikamoto Akira, Beppu Toru, Baba Hideo
Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan.
Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan Department of Multidisciplinary Treatment for Gastroenterological Cancer, Kumamoto University Hospital, Kumamoto, Japan.
Anticancer Res. 2015 Apr;35(4):2157-63.
The long-term prognosis of hepatocellular carcinoma (HCC) patients after hepatic resection (HR) remains poor because of limited liver function and frequent recurrences. We created a prognostic system of HCC based on tumor markers and Child-Pugh classification.
This study investigated 427 HCC patients and three tumor markers (alpha-fetoprotein (AFP), Lens culinaris agglutinin-reactive fraction of AFP (AFP-L3), des-γ -carboxyprothrombin (DCP)) in relation to Child-Pugh classification by the stepwise Cox regression model for establishing a tumor marker staging (TMS).
The TMS shows four levels (0/1/2/3) with 5-year recurrence rate of each stage of 76.7, 72.3, 80.9 and 100%, respectively, and 5-year overall survival of 77.0, 68.7, 52.1 and 28.9%, respectively. This TMS appears to be a better model to predict the recurrence and survival of HCC patients after hepatectomy than only the number of positive tumor markers.
TMS is a useful staging system to evaluate biological status and background liver function.
由于肝功能受限和复发频繁，肝细胞癌（HCC）患者肝切除术后的长期预后仍然较差。我们基于肿瘤标志物和Child-Pugh分级创建了一种HCC预后系统。
本研究通过逐步Cox回归模型，对427例HCC患者及三种肿瘤标志物（甲胎蛋白（AFP）、AFP的刀豆凝集素反应分数（AFP-L3）、异常凝血酶原（DCP））与Child-Pugh分级的关系进行研究，以建立肿瘤标志物分期（TMS）。
TMS分为四个级别（0/1/2/3），各阶段的5年复发率分别为76.7%、72.3%、80.9%和100%，5年总生存率分别为77.0%、68.7%、52.1%和28.9%。与仅依据阳性肿瘤标志物数量相比，TMS似乎是预测肝切除术后HCC患者复发和生存情况的更好模型。
TMS是评估生物学状态和背景肝功能的有用分期系统。
