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血清紫藤凝集素阳性的人Mac-2结合蛋白水平可预测乙型肝炎病毒相关肝细胞癌根治性切除术后的复发情况。

Serum Wisteria floribunda agglutinin-positive human Mac-2 binding protein level predicts recurrence of hepatitis B virus-related hepatocellular carcinoma after curative resection.

作者信息

Kim Hye Soo, Kim Seung Up, Kim Beom Kyung, Park Jun Yong, Kim Do Young, Ahn Sang Hoon, Han Kwang-Hyub, Park Young Nyun, Han Dai Hoon, Kim Kyung Sik, Choi Jin Sub, Choi Gi Hong, Kim Hyon-Suk

机构信息

Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.

Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.

出版信息

Clin Mol Hepatol. 2020 Jan;26(1):33-44. doi: 10.3350/cmh.2018.0073. Epub 2019 Jun 27.

Abstract

BACKGROUND/AIMS: To investigate whether serum Wisteria floribunda agglutinin-positive human Mac-2-binding protein (WFA+-M2BP) can predict the recurrence of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) after curative resection.

METHODS

Patients with chronic hepatitis B (CHB) who underwent curative resection for HCC between 2004 and 2015 were eligible for the study. Recurrence was sub-classified as early (<2 years) or late (≥2 years).

RESULTS

A total of 170 patients with CHB were selected. During the follow-up period (median, 22.6 months), 64 (37.6%) patients developed recurrence. In multivariate analyses, WFA+-M2BP level was an independent predictor of overall (hazard ratio [HR]=1.490), early (HR=1.667), and late recurrence (HR=1.416), together with male sex, des-gamma carboxyprothrombin level, maximal tumor size, portal vein invasion, and satellite nodules (all P<0.05). However, WFA+- M2BP level was not predictive of grade B-C posthepatectomy liver failure. The cutoff value that maximized the sum of sensitivity (30.2%) and specificity (90.6%) was 2.14 (area under receiver operating characteristic curve=0.632, P=0.010). Patients with a WFA+-M2BP level >2.14 experienced recurrence more frequently than those with a WFA+-M2BP level ≤2.14 (P=0.011 by log-rank test), and had poorer postoperative outcomes than those with a WFA+-M2BP level ≤2.14 in terms of overall recurrence (56.0 vs. 34.5%, P=0.047) and early recurrence (52.0 vs. 20.7%, P=0.001).

CONCLUSION

WFA+-M2BP level is an independent predictive factor of HBV-related HCC recurrence after curative resection. Further studies should investigate incorporation of WFA+-M2BP level into tailored postoperative surveillance strategies for patients with CHB.

摘要

背景/目的:探讨血清紫藤凝集素阳性的人巨噬细胞2结合蛋白(WFA+-M2BP)能否预测乙型肝炎病毒(HBV)相关肝细胞癌(HCC)根治性切除术后的复发情况。

方法

选取2004年至2015年间因HCC接受根治性切除的慢性乙型肝炎(CHB)患者进行研究。复发分为早期(<2年)或晚期(≥2年)。

结果

共入选170例CHB患者。在随访期间(中位时间为22.6个月),64例(37.6%)患者出现复发。多因素分析显示,WFA+-M2BP水平是总体复发(风险比[HR]=1.490)、早期复发(HR=1.667)和晚期复发(HR=1.416)的独立预测因素,同时还有男性、去γ羧基凝血酶原水平、最大肿瘤大小、门静脉侵犯和卫星结节(所有P<0.05)。然而,WFA+-M2BP水平不能预测B-C级肝切除术后肝衰竭。使敏感性(30.2%)和特异性(90.6%)之和最大化的临界值为2.14(受试者操作特征曲线下面积=0.632,P=0.010)。WFA+-M2BP水平>2.14的患者比WFA+-M2BP水平≤2.14的患者复发更频繁(对数秩检验P=0.011),并且在总体复发(56.0%对34.5%,P=0.047)和早期复发(52.0%对20.7%,P=0.001)方面,术后结局比WFA+-M2BP水平≤2.14的患者更差。

结论

WFA+-M2BP水平是HBV相关HCC根治性切除术后复发的独立预测因素。进一步研究应探讨将WFA+-M2BP水平纳入CHB患者的个体化术后监测策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/83d5/6940487/9a8ba83e44a2/cmh-2018-0073f1.jpg

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