Prediction of vascular invasion in hepatocellular carcinoma by next-generation des-r-carboxy prothrombin.
Prediction of vascular invasion in hepatocellular carcinoma by next-generation des-r-carboxy prothrombin.
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DOI：
10.1038/bjc.2015.423
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发表时间：
2016-01-12
影响因子：
8.8
通讯作者：
Takayama T
中科院分区：
文献类型：
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作者：
Kurokawa T;Yamazaki S;Mitsuka Y;Moriguchi M;Sugitani M;Takayama T
在肝细胞癌（HCC）中，脱-r-羧基凝血酶原（DCP）比甲胎蛋白（AFP）更准确地反映恶性潜能。下一代DCP（NX-DCP）的创建是为了克服传统DCP的一些局限性。本研究评估了NX-DCP对HCC血管浸润的预测价值。我们前瞻性研究了82例计划接受肝癌切除术的连续患者。根据有无病理性血管侵犯将患者分为两组。通过受试者工作特征曲线分析比较AFP、常规DCP和NX-DCP对血管浸润的预测能力，并评估与肿瘤标志物和血管浸润存在的相关性。21例患者（阳性组）病理证实血管侵犯，61例患者（阴性组）无血管侵犯。阳性组NX-DCP水平显著高于阴性组（510.0 mAU ml−1（10-98 450）vs 34.0 mAU ml−1（12-541），P<0.0001），而AFP水平在两组之间没有显著差异（9.7 ng ml−1（1.6-43 960.0）vs 11.0 ng ml−1（1.6-1650.0），P=0.49）。NX-DCP的曲线下面积（AUC）（AUC=0.813，灵敏度= 71.4%，1-特异性=13.1%）对于预测血管浸润具有良好的灵敏度，而AFP的AUC为0.550（灵敏度= 28.6%，1-特异性=1.60%）。确定HCC中病理性血管浸润的合适截止值为33 mm（AUC：0.783，灵敏度= 71.43%，1-特异性=11.48%）。NX-DCP水平可用于预测HCC中血管浸润的存在。
In hepatocellular carcinoma (HCC), des-r-carboxy prothrombin (DCP) more accurately reflects the malignant potential than alpha-fetoprotein (AFP). Next-generation DCP (NX-DCP) was created to overcome some of the limitations of conventional DCP. This study assessed the predictive value of NX-DCP for vascular invasion in HCC. We prospectively studied 82 consecutive patients who were scheduled to undergo resection for HCC. Patients were divided into two groups according to the presence or absence of pathological vascular invasion. The predictive powers of AFP, conventional DCP, and NX-DCP for vascular invasion were compared by receiver operating characteristic curve analysis, and correlations with tumour markers and the presence of vascular invasion were assessed. Vascular invasion was pathologically confirmed in 21 patients (positive group) and absent in 61 patients (negative group). The NX-DCP level was significantly higher in the positive group than in the negative group (510.0 mAU ml−1 (10–98 450) vs 34.0 mAU ml−1 (12–541), P<0.0001), while the AFP level did not differ significantly between the groups (9.7 ng ml−1 (1.6–43 960.0) vs 11.0 ng ml−1 (1.6–1650.0), P=0.49). The area under the curve (AUC) of NX-DCP (AUC=0.813, sensitivity=71.4%, 1−specificity=13.1%) had good sensitivity for the prediction of vascular invasion, while the AUC of AFP was 0.550 (sensitivity=28.6%, 1−specificity=1.60%). The suitable cutoff value for identifying pathological vascular invasion in HCC was 33 mm (AUC: 0.783, sensitivity=71.43%, 1−specificity=11.48%). The NX-DCP level can be used to predict the presence of vascular invasion in HCC.