Yen Yi-Hao, Liu Yueh-Wei, Li Wei-Feng, Wang Chih-Chi, Yong Chee-Chien, Lin Chih-Che, Lin Chih-Yun
Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, 123 Ta Pei Road, Kaohsiung 833401, Taiwan.
Liver Transplantation Center, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, 123 Ta Pei Road, Kaohsiung 833401, Taiwan.
Cancers (Basel). 2023 Feb 14;15(4):1203. doi: 10.3390/cancers15041203.
We evaluated whether combining the radiographic tumor burden score (TBS) and alpha-fetoprotein (AFP) level could be used to stratify overall survival (OS) among hepatocellular carcinoma (HCC) patients after liver resection (LR). Patients who underwent LR for Barcelona Clinic Liver Cancer stage 0, A, or B HCC between 2011 and 2018 were enrolled. TBS scores were calculated using the following equation: TBS = (largest tumor size (in cm)) + (tumor number). Among 743 patients, 193 (26.0%) patients had a low TBS (<2.6), 474 (63.8%) had a moderate TBS (2.6-7.9), and 75 (10.1%) had a high TBS (>7.9). Those with a TBS ≤ 7.9 and AFP < 400 ng/mL had a significantly better OS than those with a TBS > 7.9 and an AFP < 400 ng/mL ( = 0.003) or ≥ 400 ng/mL ( < 0.001). A multivariate analysis using TBS ≤ 7.9 and AFP < 400 ng/mL as the reference values showed that a TBS > 7.9 and an AFP < 400 ng/mL (hazard ratio (HR): 2.063; 95% confidence interval [CI]: 1.175-3.623; = 0.012) or ≥ 400 ng/mL (HR: 6.570; 95% CI: 3.684-11.719; < 0.001) were independent predictors of OS. In conclusion, combining radiographic TBSs and AFP levels could stratify OS among HCC patients undergoing LR.
我们评估了联合应用影像学肿瘤负荷评分（TBS）和甲胎蛋白（AFP）水平是否可用于对肝切除（LR）术后肝细胞癌（HCC）患者的总生存期（OS）进行分层。纳入了2011年至2018年间因巴塞罗那临床肝癌0期、A期或B期HCC接受LR的患者。TBS评分通过以下公式计算：TBS =（最大肿瘤直径（cm））+（肿瘤数量）。在743例患者中，193例（26.0%）患者TBS较低（<2.6），474例（63.8%）患者TBS中等（2.6 - 7.9），75例（10.1%）患者TBS较高（>7.9）。TBS≤7.9且AFP<400 ng/mL的患者的OS显著优于TBS>7.9且AFP<400 ng/mL的患者（P = 0.003）或AFP≥400 ng/mL的患者（P<0.001）。以TBS≤7.9且AFP<400 ng/mL作为参考值进行多因素分析显示，TBS>7.9且AFP<400 ng/mL（风险比（HR）：2.063；95%置信区间[CI]：1.175 - 3.623；P = 0.012）或AFP≥400 ng/mL（HR：6.570；95%CI：3.684 - 11.719；P<0.001）是OS的独立预测因素。总之，联合影像学TBS和AFP水平可对接受LR的HCC患者的OS进行分层。
