Chou Hong-Shiue, Lee Chen-Fang, Hung Hao-Chien, Lai Yin, Lee Jin-Chiao, Wang Yu-Chao, Cheng Chih-Hsien, Wu Tsung-Han, Wu Ting-Jung, Chan Kun-Ming, Lee Wei-Chen
Division of Liver and Transplantation Surgery, Chang-Gung Memorial Hospital, Taoyuan, Taiwan.
Chang-Gung University College of Medicine, Taoyuan, Taiwan.
Langenbecks Arch Surg. 2025 Apr 9;410(1):124. doi: 10.1007/s00423-025-03675-y.
Following liver resection (LR), recurrence is critical to the prognosis of hepatocellular carcinoma (HCC). A higher level of alpha-fetoprotein (AFP) is typically associated with poor prognosis and recurrence concerns. Specifically, we attempted to determine whether high AFP (> 1,000ng/ml) and other potentially relevant factors affect survivals of patients with BCLC stage 0 HCC after LR.
This retrospective study focused on 223 patients who received LR for stage 0 HCC of BCLC between 2004 and 2012. In patients with a low AFP (n = 200) and a high AFP (n = 23), we conducted chi-squares, independent t-test, Cox regression, and Kaplan-Meier survival analyses to investigate the relationship between clinicopathologic variables and outcomes.
The long-term disease-free survival (DFS) (p = 0.799) and the overall survival (OS) (p = 0.942) between the low and high AFP groups were comparable. The two groups' clinicopathologic features-tumor size, presence of a tumor capsule, cirrhosis, histology activity index (HAI), and microvascular invasion-appear to be similar. Additionally, we observed significant associations between HCC recurrence and ICG R15, HAI score, and cirrhosis, but not AFP.
In stage 0 HCC, the consideration of curative-intent therapy in these patients should begin as soon as possible, irrespective of AFP levels.
肝切除术后，复发是影响肝细胞癌（HCC）预后的关键因素。甲胎蛋白（AFP）水平升高通常与预后不良及复发风险相关。具体而言，我们试图确定高AFP水平（>1000ng/ml）及其他潜在相关因素是否会影响BCLC 0期HCC患者肝切除术后的生存情况。
这项回顾性研究聚焦于2004年至2012年间接受BCLC 0期HCC肝切除术的223例患者。对于低AFP水平患者（n = 200）和高AFP水平患者（n = 23），我们进行了卡方检验、独立t检验、Cox回归分析和Kaplan-Meier生存分析，以研究临床病理变量与预后之间的关系。
低AFP组和高AFP组之间的长期无病生存率（DFS）（p = 0.799）和总生存率（OS）（p = 0.942）相当。两组的临床病理特征，如肿瘤大小、肿瘤包膜、肝硬化、组织学活动指数（HAI）和微血管侵犯，似乎相似。此外，我们观察到HCC复发与吲哚菁绿滞留率15分钟（ICG R15）、HAI评分和肝硬化之间存在显著关联，但与AFP无关。
在0期HCC中，无论AFP水平如何，应尽早考虑对这些患者进行根治性治疗。
