Department of Surgery, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, China.
Department of Environmental Health and Occupational Medicine, West China School of Public Health, Sichuan University, Chengdu, 610041, Sichuan Province, China.
Surg Oncol. 2019 Jun;29:159-167. doi: 10.1016/j.suronc.2019.05.013. Epub 2019 May 21.
Serum ferritin (SF) may have a close relationship with the tumor. But no study has investigated the prognostic value of SF in hepatocellular carcinoma (HCC) patients receiving curative resection yet. Aim of this study is to explore the role of preoperative SF in survival outcomes of such patients.
We retrospectively analyzed 427 HCC patients who received curative hepatic resection in our medical center. Significant clinical and pathological data along with the association between SF and clinicopathological parameters were compared and analyzed. The prognostic significance of SF was determined by Kaplan-Meier analysis and the Cox proportional hazards regression model.
The optimal cut-off value of SF for overall survival (OS) was 267 ng/ml. Preoperative SF level could predict OS (P = 0.001, HR = 1.651, 95%CI: 1.213-2.247) and recurrence-free survival (RFS) (P < 0.001, HR = 1.570, 95%CI: 1.221-2.018) independent of other prognostic factors. Patients with a low SF were more likely to have both favorable OS and RFS (both P < 0.001), and vice versa. The 1-, 3-, and 5-year OS and RFS rates were 91.4%, 80.1%, 71.7%, and 78.0%, 53.0%, 47.3% in low SF group, and 91.6%, 60.2%, 45.2%, and 61.3%, 36.4%, 29.0% in high SF group, respectively.
Preoperative SF was a simple, inexpensive, convenient and reliable prognostic factor that could predict survival outcomes in HCC patients who received radical hepatic resection.
血清铁蛋白（SF）可能与肿瘤密切相关。但是，尚无研究调查 SF 在接受根治性肝切除术的肝细胞癌（HCC）患者中的预后价值。本研究旨在探讨术前 SF 在这类患者生存结局中的作用。
我们回顾性分析了在我院接受根治性肝切除术的 427 例 HCC 患者。比较并分析了重要的临床和病理数据以及 SF 与临床病理参数之间的关系。通过 Kaplan-Meier 分析和 Cox 比例风险回归模型确定 SF 的预后意义。
SF 对总生存期（OS）的最佳截断值为 267ng/ml。术前 SF 水平可预测 OS（P=0.001，HR=1.651，95%CI：1.213-2.247）和无复发生存期（RFS）（P<0.001，HR=1.570，95%CI：1.221-2.018），独立于其他预后因素。SF 水平低的患者具有更好的 OS 和 RFS（均 P<0.001），反之亦然。低 SF 组的 1、3 和 5 年 OS 和 RFS 率分别为 91.4%、80.1%、71.7%和 78.0%、53.0%、47.3%，高 SF 组分别为 91.6%、60.2%、45.2%和 61.3%、36.4%、29.0%。
术前 SF 是一种简单、经济、方便、可靠的预后因素，可预测接受根治性肝切除术的 HCC 患者的生存结局。
