Scoring system based on tumor markers and Child-Pugh classification for HCC patients who underwent liver resection.
Scoring system based on tumor markers and Child-Pugh classification for HCC patients who underwent liver resection.
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发表时间：
2015-04
影响因子：
2
通讯作者：
S. Nakagawa;H. Hayashi;H. Nitta;H. Okabe;Keita Sakamoto;T. Higashi;Hideyuki Kuroki;K. Imai;
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作者：
S. Nakagawa;H. Hayashi;H. Nitta;H. Okabe;Keita Sakamoto;T. Higashi;Hideyuki Kuroki;K. Imai;
背景肝细胞癌患者肝切除术后长期预后较差，主要原因是肝功能受限和复发频繁。我们建立了一个基于肿瘤标志物和Child-Pugh分级的肝细胞癌预后系统。患者和方法采用逐步COX回归模型对427例肝癌患者和3种肿瘤标志物(甲胎蛋白、晶状体凝集素反应部分甲胎蛋白、DES-γ-羧基凝血酶原)与ChildPugh分级的关系进行研究，建立肿瘤标志物分期。结果TMS分期为0/1/2/3，5年复发率分别为76.7%、72.3%、80.9%和100%，5年总生存率分别为77.0%、68.7%、52.1%和28.9%。与仅用肿瘤标志物阳性的数量相比，TMS是预测肝切除后肝癌患者复发和生存的更好的模型。结论TMS是一种有用的分期系统，可用于评估肿瘤的生物学状态和背景肝功能。
BACKGROUND The long-term prognosis of hepatocellular carcinoma (HCC) patients after hepatic resection (HR) remains poor because of limited liver function and frequent recurrences. We created a prognostic system of HCC based on tumor markers and Child-Pugh classification. PATIENTS AND METHODS This study investigated 427 HCC patients and three tumor markers (alpha-fetoprotein (AFP), Lens culinaris agglutinin-reactive fraction of AFP (AFP-L3), des-γ -carboxyprothrombin (DCP)) in relation to Child-Pugh classification by the stepwise Cox regression model for establishing a tumor marker staging (TMS). RESULTS The TMS shows four levels (0/1/2/3) with 5-year recurrence rate of each stage of 76.7, 72.3, 80.9 and 100%, respectively, and 5-year overall survival of 77.0, 68.7, 52.1 and 28.9%, respectively. This TMS appears to be a better model to predict the recurrence and survival of HCC patients after hepatectomy than only the number of positive tumor markers. CONCLUSION TMS is a useful staging system to evaluate biological status and background liver function.