Lens culinaris agglutinin-reactive fraction of AFP is a useful prognostic biomarker for survival after repeat hepatic resection for HCC
Lens culinaris agglutinin-reactive fraction of AFP is a useful prognostic biomarker for survival after repeat hepatic resection for HCC
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DOI：
10.1111/j.1440-1746.2010.06532.x
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发表时间：
2011-04-01
影响因子：
4.1
通讯作者：
Fujii, Hideki
中科院分区：
文献类型：
--
作者：
Matsuda, Masanori;Asakawa, Masami;Fujii, Hideki
背景和目的：复发性肝细胞癌（HCC）的重复肝切除术可有效改善选定患者的长期预后。在本研究中，我们试图确定的预后因素影响整体和无复发生存后的第二次hepatic surgery.Methods：从1997年9月1日至2009年9月30日，329例连续肝癌患者在山梨大学医院，日本进行手术探查。其中，35例患者接受了根治性第二次肝切除术。结果：单因素分析显示，Child-Pugh B、甲胎蛋白透镜凝集素反应分数（AFP-L3）值大于15%和多发性肿瘤与总生存率显著较差相关（分别为P = 0.010、P = 0.0003和P = 0.037），且仅AFP-L3 > 15%与第二次肝切除后无复发生存率显著较差相关（P = 0.008）。通过多因素分析，只有AFP-L3 > 15%是不良总生存率的独立预测因素。27例AFP-L3水平低（< 15%）的HCC患者第二次肝切除后的1、3和5年生存率分别为100%、100%和91.7%，8例AFP-L3水平高（> 15%）的HCC患者第二次肝切除后的相应生存率分别为100%、47.6%和23.8%。术前AFP-L3水平是再次肝切除术后生存的有用预后生物标志物。
Background and Aim:Repeat hepatic resection for recurrent hepatocellular carcinoma (HCC) is effective in improving long-term outcome in selected patients. In the present study, we attempted to identify the prognostic factors influencing overall and recurrence-free survival after the second hepatic resection.Methods:From 1 September 1997 to 30 September 2009, 329 consecutive patients with HCC underwent surgical exploration at Yamanashi University Hospital, Japan. Of these, 35 patients underwent curative, second hepatic resection. The survival results in the 35 patients were analyzed retrospectively, and prognostic factors were determined.Results:The univariate analysis revealed that Child-Pugh B, a Lens culinaris agglutinin-reactive fraction of alpha-fetoprotein (AFP-L3) value more than 15%, and multiple tumors, were associated with significantly worse overall survival (P = 0.010, P = 0.0003, and P = 0.037, respectively) and only AFP-L3 > 15% was associated with significantly worse recurrence-free survival after the second hepatic resection (P = 0.008). By multivariate analysis, only AFP-L3 > 15% was an independent predictor of adverse overall survival. The 1-, 3-, and 5-year survival rates after the second hepatic resection of 27 HCC patients with low AFP-L3 (< 15%) were 100%, 100%, and 91.7%, respectively, whereas the corresponding survival rates of eight HCC patients with high AFP-L3 (> 15%) were 100%, 47.6%, and 23.8%, respectively.Conclusions:The preoperative AFP-L3 level was a useful prognostic biomarker for survival after repeat hepatic resection.