Liver Disease Center, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.
Department of Hepatobiliary and Pancreatic Surgery Center, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.
Biomed Res Int. 2019 Sep 29;2019:6959637. doi: 10.1155/2019/6959637. eCollection 2019.
Little is known about the association between cancer antigen 125 (MUC16/CA125) concentrations and tumor diameter of patients with hepatocellular carcinoma (HCC) and low AFP levels. To fill this gap in our knowledge, we conducted a retrospective study of 427 patients with HCC with AFP ≤200 ng/mL who underwent R0 resection at our center.
The associations between CA125 concentrations and patients' clinicopathological characteristics were analyzed. Survival vs CA125 levels was also evaluated between patient groups with CA125 ≤30 U/mL or CA125 >30 U/mL. Independent risk factors of disease-free survival (DFS) and overall survival (OS) were analyzed with Cox hazard regression model.
Elevated preoperative serum CA125 was significantly associated with maximal tumor diameter (MTD) >5 cm and female sex ( < 0.001 and =0.044, respectively). The DFS and OS of patients with CA125 ≤30 U/mL ( = 392) were significantly higher compared with those with CA125 >30 U/mL ( = 35) (=0.003 and =0.001 respectively). Multivariate analysis revealed that MTD >5 cm was an independent risk factor of DFS (HR = 1.891, 95% CI: 1.379-2.592, < 0.001) and OS (2.709, 1.848-3.972, < 0.001).
In conclusion, elevated preoperative serum CA125 predicted larger tumor diameter and poor prognosis after patients with HCC with AFP ≤200 ng/mL underwent R0 resection, which may be explained by the elevation of the preoperative serum CA125 level significantly associated with MTD>5 cm.
目前对于甲胎蛋白（AFP）水平较低的肝细胞癌（HCC）患者，癌抗原 125（MUC16/CA125）浓度与肿瘤直径之间的关联知之甚少。为了填补这一知识空白，我们对在我院接受 R0 切除的 427 例 AFP≤200ng/mL 的 HCC 患者进行了回顾性研究。
分析 CA125 浓度与患者临床病理特征之间的关系。还评估了 CA125≤30U/mL 或 CA125>30U/mL 的患者组之间的生存与 CA125 水平之间的关系。使用 Cox 风险回归模型分析无病生存（DFS）和总生存（OS）的独立危险因素。
术前血清 CA125 升高与最大肿瘤直径（MTD）>5cm 和女性（<0.001 和=0.044）显著相关。CA125≤30U/mL（n=392）患者的 DFS 和 OS 明显高于 CA125>30U/mL（n=35）（=0.003 和=0.001）。多变量分析显示，MTD>5cm 是 DFS（HR=1.891，95%CI：1.379-2.592，<0.001）和 OS（2.709，1.848-3.972，<0.001）的独立危险因素。
总之，在 AFP≤200ng/mL 的 HCC 患者接受 R0 切除术后，术前血清 CA125 升高提示肿瘤直径较大且预后较差，这可能是由于术前血清 CA125 水平升高与 MTD>5cm 显著相关所致。
