Combination of morphologic criteria and α-fetoprotein in selection of patients with hepatocellular carcinoma for liver transplantation minimizes the problem of posttransplant tumor recurrence.
Combination of morphologic criteria and α-fetoprotein in selection of patients with hepatocellular carcinoma for liver transplantation minimizes the problem of posttransplant tumor recurrence.
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结合形态学标准和甲胎蛋白选择肝细胞癌患者进行肝移植可最大限度地减少移植后肿瘤复发的问题。
DOI：
10.1007/s00268-014-2647-3
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发表时间：
2014-10
影响因子：
2.6
通讯作者：
Krawczyk, Marek
中科院分区：
文献类型：
--
作者：
Grat, Micha;Kornasiewicz, Oskar;Lewandowski, Zbigniew;Holowko, Waclaw;Grat, Karolina;Kobryn, Konrad;Patkowski, Waldemar;Zieniewicz, Krzysztof;Krawczyk, Marek
血清甲胎蛋白浓度（AFP）可能是选择肝细胞癌（HCC）患者进行肝移植（LT）的形态学标准的有用补充。本研究的目的是评估 AFP 在现有标准下选择移植后肿瘤复发风险最小的 HCC 患者中的作用。这项回顾性队列研究基于在同一机构接受 LT 后的 121 名 HCC 患者。 AFP 被评估为移植后肿瘤复发的预测因子，符合米兰、加州大学旧金山分校 (UCSF) 和 Up-to 7 标准。 AFP 与 HCC 复发风险之间几乎呈线性相关（线性效应 p < 0.001；非线性效应 p = 0.434）。 AFP 预测患者的 HCC 复发 (1) 超出米兰标准（p < 0.001；最佳截止值 200 ng/ml）； (2) 在 UCSF 标准之内（p = 0.001；最佳截止值 100 ng/ml）并超出标准（p = 0.015；最佳截止值 200 ng/ml）； (3) 在 Up-to-7 标准内（p = 0.001；最佳截止值 100 ng/ml）或超出该标准（p = 0.023；最佳截止值 100 ng/ml），但不在米兰标准内的患者（p = 0.834）。符合 UCSF 和 Up-to-7 标准且 AFP 水平 <100 ng/ml 的患者表现出优异的 (100%) 5 年无复发生存率，显着高于符合 UCSF (p = 0.005) 或 Up-to-7 (p = 0.001) 标准且 AFP 水平高于估计截止值或高于 AFP 水平低于估计截止值的患者。将 UCSF 和 Up-to-7 标准与 AFP 水平 <100 ng/ml 相结合，肿瘤复发风险极低。因此，这种组合可能有助于选择 HCC 患者进行 LT。
Serum α-fetoprotein concentration (AFP) might be a useful addition to morphologic criteria for selecting patients with hepatocellular carcinoma (HCC) for liver transplantation (LT). The aim of this study was to evaluate the role of AFP in selecting HCC patients at minimal risk of posttransplant tumor recurrence in the setting of existing criteria. This retrospective cohort study was based on 121 HCC patients after LT performed at a single institution. AFP was evaluated as a predictor of posttransplant tumor recurrence with respect to fulfillment of the Milan, University of California, San Francisco (UCSF), and Up-to-7 criteria. There was a nearly linear association between AFP and the risk of HCC recurrence (p < 0.001 for linear effect; p = 0.434 for nonlinear effect). AFP predicted HCC recurrence in patients (1) beyond the Milan criteria (p < 0.001; optimal cutoff 200 ng/ml); (2) within the UCSF criteria (p = 0.001; optimal cutoff 100 ng/ml) and beyond them (p = 0.015; optimal cutoff 200 ng/ml); and (3) within the Up-to-7 criteria (p = 0.001; optimal cutoff 100 ng/ml) and beyond them (p = 0.023; optimal cutoff 100 ng/ml) but not in patients within the Milan criteria (p = 0.834). Patients within either UCSF and Up-to-7 criteria with AFP level <100 ng/ml exhibited superior (100 %) 5-year recurrence-free survival—significantly higher than those within UCSF (p = 0.005) or Up-to-7 (p = 0.001) criteria with AFP levels higher than the estimated cutoffs or beyond with AFP levels less than the estimated cutoffs. Combining the UCSF and Up-to-7 criteria with an AFP level <100 ng/ml is associated with minimal risk of tumor recurrence. Hence, this combination might be useful for selecting HCC patients for LT.
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影响因子：
51.1
作者：
Clavien, Pierre-Alain;Lesurtel, Mickael;Bossuyt, Patrick M. M.;Gores, Gregory J.;Langer, Bernard;Perrier, Arnaud
通讯作者：
Perrier, Arnaud
影响因子：
3.2
作者：
Lei, J. Y.;Yan, L. N.
通讯作者：
Yan, L. N.
影响因子：
3
作者：
Graham，Jay A.;Melancon，Joseph K.;Johnson，Lynt B.
通讯作者：
Johnson，Lynt B.
影响因子：
0.9
作者：
Grat, M.;Kornasiewicz, O.;Krawczyk, M.
通讯作者：
Krawczyk, M.
DOI：
10.1155/2007/206383
发表时间：
2007-01-01
期刊：
CANADIAN JOURNAL OF GASTROENTEROLOGY
影响因子：
--
作者：
Han, Kathy;Tzimas, George N.;Deschenes, Marc
通讯作者：
Deschenes, Marc