Prognostic significance of a combination of pre- and post-treatment tumor markers for hepatocellular carcinoma curatively treated with hepatectomy
Prognostic significance of a combination of pre- and post-treatment tumor markers for hepatocellular carcinoma curatively treated with hepatectomy
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DOI：
10.1016/j.jhep.2012.07.018
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发表时间：
2012-12-01
影响因子：
25.7
通讯作者：
Maeda, Atsuyuki
中科院分区：
文献类型：
--
作者：
Toyoda, Hidenori;Kumada, Takashi;Maeda, Atsuyuki
背景 82 目的：之前的研究报道，肝细胞癌 (HCC)、甲胎蛋白 (AFP)、小扁豆凝集素反应性 APP (AFP-L3) 和脱伽马羧基凝血酶原 (DCP) 三种肿瘤标志物的组合能够区分 HCC 患者的生存情况。然而，在这些研究中，研究人群包括接受各种治疗方式的所有患者，并且仅在治疗前测量肿瘤标志物。我们研究了治疗前和治疗后测量的这些 HCC 肿瘤标志物组合对接受肝切除术治疗的患者的生存和复发的预后价值。方法：对总共 173 名因原发性非复发性 HCC 接受肝切除术的患者进行了分析。根据治疗前后升高的肿瘤标志物数量比较肿瘤特征、术后生存率和复发率。结果：治疗前升高的肿瘤标志物数量分别与肿瘤大小、门静脉侵犯率和肿瘤分化程度之间的相关性强于治疗后升高的肿瘤标志物数量之间的相关性。相比之下，治疗后升高的肿瘤标志物数量与治疗前相比表现出优异的区分治疗后生存率和复发率的能力，并且在多变量分析中是与生存和复发相关的独立因素。结论：与治疗前测量的肿瘤标志物组合相比，肝切除后测量的肿瘤标志物组合对于肝切除术治疗的HCC患者术后生存和复发具有更好的区分能力。 (C) 2012 年欧洲肝脏研究协会。由 Elsevier B.V. 出版。保留所有权利。
Background 82 Aims: Previous studies reported that the combination of three tumor markers for hepatocellular carcinoma (HCC), alpha-fetoprotein (AFP), Lens culinaris agglutinin-reactive APP (AFP-L3), and des-gamma-carboxy prothrombin (DCP), has the ability to discriminate survival among patients with HCC. In those studies, however, the study population included all patients with various treatment modalities, and tumor markers were measured only before treatment. We investigated the prognostic value of a combination of these tumor markers for HCC, measured before and after treatment, on survival and recurrence in patients treated with hepatectomy.Methods: A total of 173 patients who underwent hepatectomy for primary, non-recurrent HCC were analyzed. Tumor characteristics, postoperative survival, and recurrence rates were compared according to the number of elevated tumor markers measured before and after treatment.Results: The correlation between the number of elevated tumor markers before treatment and tumor size, rate of portal vein invasion, and tumor differentiation, respectively, was stronger than that between the number of elevated tumor markers after treatment. In contrast, the number of elevated tumor markers after treatment displayed an excellent ability to discriminate post-treatment survival and recurrence rates compared to that before treatment, and was an independent factor associated with survival and recurrence in multivariate analysis.Conclusions: The combination of tumor markers measured after hepatectomy has a better discriminatory ability for postoperative survival and recurrence in HCC patients treated with hepatectomy in comparison to the combination of tumor markers measured before treatment. (C) 2012 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.