Preoperative Carbohydrate Antigen 19-9: Its Neglected Role in Alpha-Fetoprotein-Negative Hepatocellular Carcinoma Patients
Preoperative Carbohydrate Antigen 19-9: Its Neglected Role in Alpha-Fetoprotein-Negative Hepatocellular Carcinoma Patients
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DOI：
10.1007/s11605-017-3528-5
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发表时间：
2017-12-01
影响因子：
3.2
通讯作者：
Guo, Rong-Ping
中科院分区：
文献类型：
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作者：
Lu, Liang-He;Zhang, Yong-Fa;Guo, Rong-Ping
本研究旨在探讨术前碳水化合物抗原19-9 （CA19-9）水平对甲胎蛋白（AFP）阴性（AFP < 25 ng/ml）肝细胞癌（HCC）患者预后的影响。从2004年12月到2013年12月，纳入了750例经根治性切除后诊断为afp阴性HCC的患者。进行单因素和多因素分析，以明确总生存期（OS）和无病生存期（DFS）的预后因素。术前CA19-9的最佳截断点为32.6 U/ml，曲线下面积为0.640。CA19-9 > 32.6 U/ml组1年、3年和5年OS分别为88.4、72.2和57.0%,CA19-9 > 32.6 U/ml组97.0、83.3和79.9% （P < 0.001）。CA19-9浓度为32.6 U/ml组的1年、3年和5年DFS分别为71.8、47.7和34.8%，CA19-9浓度为32.6 U/ml组的80.8、63.6和55.5% （P < 0.001）。多因素分析显示，CA19-9 > 32.6 U/ml是OS和DFS最显著的不利预测因子之一（P < 0.001）。术前CA19-9 > 32.6 U/ml是预后不良的预测指标，可作为afp阴性HCC治疗中患者选择的预后指标。
The study aimed to investigate the prognostic role of the preoperative carbohydrate antigen 19-9 (CA19-9) level in alpha-fetoprotein (AFP)-negative (AFP < 25 ng/ml) hepatocellular carcinoma (HCC) patients.From December 2004 to December 2013, 750 patients diagnosed with AFP-negative HCC following curative resection were enrolled. Both univariate and multivariate analyses were performed to clarify the prognostic factors for overall survival (OS) and disease-free survival (DFS).The optimal cutoff point for preoperative CA19-9 was 32.6 U/ml, and the value of the area under the curve was 0.640. The 1-, 3-, and 5-year OS rates were 88.4, 72.2, and 57.0%, respectively, for the CA19-9 > 32.6 U/ml group and 97.0, 83.3, and 79.9%, respectively, for the CA19-9 ae 32.6 U/ml group (P < 0.001). The 1-, 3-, and 5-year DFS rates were 71.8, 47.7, and 34.8%, respectively, for the CA19-9 > 32.6 U/ml group and 80.8, 63.6, and 55.5%, respectively, for the CA19-9 ae 32.6 U/ml group (P < 0.001). The multivariate analysis showed that CA19-9 > 32.6 U/ml was one of the most significant unfavorable predictors of OS and DFS (P < 0.001 for both).Preoperative CA19-9 > 32.6 U/ml is a predictor of dismal prognosis and can be employed as a prognostic marker for patient selection in AFP-negative HCC management.