Tadokoro Takeshi, Kobayashi Tsuyoshi, Honmyo Naruhiko, Kuroda Shintaro, Ohira Masahiro, Hashimoto Masakazu, Oishi Koichi, Oshita Akihiko, Abe Tomoyuki, Onoe Takashi, Kohashi Toshihiko, Ohdan Hideki
Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Science, Hiroshima University, Hiroshima, Japan.
HiSCO: Hiroshima Surgical Study Group of Clinical Oncology, Hiroshima, Japan.
Ann Surg Oncol. 2025 Mar;32(3):1973-1984. doi: 10.1245/s10434-024-16650-6. Epub 2024 Dec 10.
This study aimed to investigate the association between a new biomarker that incorporates albumin (Alb) and butyrylcholinesterase (BCHE) levels, as well as the prognosis of hepatocellular carcinoma (HCC) after hepatectomy.
The study enrolled 1712 patients who underwent primary hepatectomy for HCC between January 2003 and December 2019 at seven institutions belonging to the Hiroshima Surgical Study Group of Clinical Oncology. The entire dataset was randomly split into discovery and validation cohorts in a 7:3 ratio. The product of the preoperative Alb and BCHE levels was defined as the ABC. In the discovery cohort, the patients in the high-ABC group (≥ 951) were compared with those in the low-ABC group (< 951). These findings then were confirmed in the validation cohort.
In the discovery cohort, a significant difference was observed in the 5-year survival rate between the high- and low-ABC groups (p < 0.001), and ABC was identified as an independent prognostic factor for HCC. Similarly, in the validation cohort, a significant difference was observed in the 5-year survival rate between the high- and low-ABC groups (p < 0.001), and ABC was identified as an independent prognostic factor for HCC. Furthermore, in the discovery and validation cohorts, significant differences in the early recurrence rate between the two groups were observed (p < 0.001 and p = 0.020, respectively).
For patients with HCC, ABC is a useful predictive biomarker because it can be calculated in a simple manner and because it provides accurate prognostic information.
本研究旨在探讨一种结合白蛋白（Alb）和丁酰胆碱酯酶（BCHE）水平的新型生物标志物与肝细胞癌（HCC）肝切除术后预后之间的关联。
本研究纳入了2003年1月至2019年12月期间在广岛临床肿瘤外科研究组所属的7家机构接受原发性肝癌肝切除术的1712例患者。整个数据集以7:3的比例随机分为发现队列和验证队列。术前Alb和BCHE水平的乘积定义为ABC。在发现队列中，将高ABC组（≥951）的患者与低ABC组（<951）的患者进行比较。然后在验证队列中证实这些发现。
在发现队列中，高ABC组和低ABC组之间的5年生存率存在显著差异（p<0.001），ABC被确定为HCC的独立预后因素。同样，在验证队列中，高ABC组和低ABC组之间的5年生存率存在显著差异（p<0.001），ABC被确定为HCC的独立预后因素。此外，在发现队列和验证队列中，两组之间的早期复发率也存在显著差异（分别为p<0.001和p=0.020）。
对于HCC患者，ABC是一种有用的预测生物标志物，因为它可以简单地计算出来，并且可以提供准确的预后信息。
