Moteleub Hend Naguib Abd El, Moety Amr Ali Abd El, Baddour Nahed Mohammed, Shendidi Assem Ahmed El
Hepatology Unit, Internal Medicine Department, Faculty of Medicine, Alexandria University, Egypt.
Pathology Department, Faculty of Medicine, Alexandria University, Egypt.
Clin Exp Hepatol. 2020 Jun;6(2):77-84. doi: 10.5114/ceh.2019.95115. Epub 2020 May 8.
Microwave ablation (MWA) for treatment of hepatocellular carcinoma (HCC) is a new promising modality. The prognosis after treatment is mainly linked to the recurrence. We aimed to investigate the predictive value of α-fetoprotein (AFP) score and Aurora B kinase (AURKB) in HCC recurrence after MWA.
A cross-sectional study where 25 early-stage HCC patients (Barcelona Clinic Liver Cancer 0/A-B) were treated with MWA. Tumor biopsies were obtained just prior to MWA and assessed for WHO pathological grade and AURKB expression by immunohistochemistry. AFP score was calculated and a cut-off value of 2 classifies patients into high and low risk of recurrence. After achieving complete ablation, patients were followed every 3 months for 1 year by triphasic CT to detect recurrence.
Child-Pugh classification has no significant impact on prognosis of HCC after MWA (χ = 1.924, = 0.165). Serum AFP level and AFP score can effectively predict the response to MWA among HCC patients (χ = 6.451, = 0.031) (χ = 9.0, = 0.003), respectively. AFP score was strongly associated with the pathological grade of the tumor ( = 0.467, = 0.019). AURKB was over-expressed in tumoral more than non-tumoral specimens ( < 0.001). It was correlated with the size of the tumor, the number of tumor nodules and the pathological grade of the tumor ( < 0.05) but has no role in predicting recurrence after MWA ( = 0.869).
AFP score but not AURKB can predict the risk of recurrence of HCC after MWA.
微波消融（MWA）治疗肝细胞癌（HCC）是一种前景广阔的新方法。治疗后的预后主要与复发相关。我们旨在研究甲胎蛋白（AFP）评分和极光激酶B（AURKB）对MWA治疗后HCC复发的预测价值。
一项横断面研究，对25例早期HCC患者（巴塞罗那临床肝癌分期0/A - B）进行MWA治疗。在MWA治疗前获取肿瘤活检组织，通过免疫组化评估WHO病理分级和AURKB表达。计算AFP评分，以2分为临界值将患者分为高复发风险和低复发风险。在实现完全消融后，通过三期CT对患者进行为期1年、每3个月一次的随访以检测复发情况。
Child - Pugh分级对MWA治疗后HCC的预后无显著影响（χ = 1.924，P = 0.165）。血清AFP水平和AFP评分分别能有效预测HCC患者对MWA的反应（χ = 6.451，P = 0.031）（χ = 9.0，P = 0.003）。AFP评分与肿瘤的病理分级密切相关（r = 0.467，P = 0.019）。AURKB在肿瘤组织中的表达高于非肿瘤组织（P < 0.001）。它与肿瘤大小、肿瘤结节数量和肿瘤病理分级相关（P < 0.05），但在预测MWA治疗后的复发方面无作用（P = 0.869）。
AFP评分而非AURKB能够预测MWA治疗后HCC的复发风险。
