Studies on the correlation among the fucosylation index, concentration of α-fetoprotein and des-γ-carboxy prothrombin as prognostic indicators in hepatocellular carcinoma
Studies on the correlation among the fucosylation index, concentration of α-fetoprotein and des-γ-carboxy prothrombin as prognostic indicators in hepatocellular carcinoma
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DOI：
10.1016/s1386-6346(03)00266-3
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发表时间：
2003-12-01
影响因子：
4.2
通讯作者：
Kawai, K
中科院分区：
文献类型：
--
作者：
Igarashi, H;Aoyagi, Y;Kawai, K
我们以前的研究结果表明，岩藻糖基化指数（FI）被认为是一个有用的预后因素在肝细胞癌（HCC）患者。另一方面，甲胎蛋白（AFP）和脱-γ-羧基凝血酶原（DCP）的血清浓度被视为预后指标。然而，FI、AFP和DCP作为预后因素之间的关系尚不清楚。本研究的目的是阐明这三个预后因素之间的相关性。1990 ~ 1998年176例治疗前血清AFP升高> 30 ng/ml的HCC患者进行了检测。在透镜凝集素存在下，通过交叉免疫亲和电泳测定这些患者的FI。AFP的FI定义为L.总AFP中的culinaris凝集素（LCA）反应性物质（与U组分相同）。还测量了DCP的血清浓度。入组的HCC患者接受了经导管动脉栓塞、化疗栓塞、经皮乙醇注射和/或经皮微波凝固治疗。目前的患者状况是2001年3月底确认的状况。考克斯比例风险模型分析显示FI、AFP和DCP是显著的预后因素。当FI、AFP和DCP的暂定分界水平分别设定为18%、200 ng/ml和0.06任意单位（Au）/ml时，获得了以下用于HCC患者诊断的结果。首先，三个可选标记物中有一个超过分界水平的组的存活率显著低于其他组的存活率，其他组的可选标记物分别等于或小于分界水平。其次，三个可选标志物中有两个超过分界水平的组的存活率低于其他两个可选标志物等于或小于分界水平的组的存活率，具有高度显著性。相反，在三种可选标记物中的两种显示不一致结果的组之间，存活率没有统计学显著差异或减弱（高FI和低AFP对低FI和高AFP，低FI和高DCP对高FI和低DCP，高DCP和低AFP对低DCP和高AFP）。最后，我们比较了肝癌组之间的生存率，其可选的一个标志物超过分界线，其预后因子等于或小于分界线，另一个肝癌组，其可选的一个标志物等于或小于分界线，其预后因子超过分界线，以重新确定每个预后因素的权重。这些比较与考克斯分析一起显示，生存率中每个预后因素的权重依次为DCP、FI和AFP。目前的研究表明，测量FI，AFP和DCP从血清中的初始治疗前改善预后估计和评价的治疗结果与HCC患者。(C)2003 Elsevier B. V.保留所有权利。
Our previous results showed that the fucosylation index (FI) was considered to be a useful prognostic factor in patients with hepatocellular carcinoma (HCC). On the other hand, serum concentrations of alpha-fetoprotein (AFP) and des-gamma-carboxy prothrombin (DCP) were regarded as prognostic indicators. However, the relationship among FI, AFP, and DCP as prognostic factors remained unknown. The aim of this study was to elucidate the correlation among these three prognostic factors. One hundred and seventy-six patients with HCC from 1990 to 1998, who showed increment of serum AFP concentrations more than 30 ng/ml before treatment, were examined in the present study. FI was determined in these patients by crossed immumoaffino-electrophoresis in the presence of Lens culinaris agglutinin. FI of AFP was defined as the percentage of the L. culinaris agglutinin (LCA)-reactive species in total AFP (same as U fraction). Serum concentrations of DCP were also measured. Enrolled patients with HCC underwent transcatheter arterial embolization, chemoembolization, percutaneous ethanol injection, and/or percutaneous microwave coagulation therapy. The current patients status was the one which was confirmed at the end of March 2001. Analysis by the Cox's proportional hazards model showed that FI, AFP, and DCP were significant prognostic factors. When the tentative demarcation levels of FI, AFP, and DCP were set at 18%, 200 ng/ml, and 0.06 arbitrary units (AU)/ml, respectively, the following results for the prognostication of patients with HCC were obtained. First, the survival rates in the groups with one out of the three optional markers over the demarcation level were significantly lower than the survival rates of other groups, whose optional one marker was equal to or less than the demarcation level, respectively. Next, the survival rates in the groups in which two out of three optional markers were over the demarcation levels were lower than the survival rates of other groups, whose optional two markers were equal to or less than the demarcation levels, with high significance. On the contrary, there was absence or attenuation of statistically significant differences in the survival rates between the groups in which two of the three optional markers showed no accordant results (high FI and low AFP versus low FI and high AFP, low FI and high DCP versus high FI and low DCP, high DCP and low AFP versus low DCP and high AFP). Finally, we compared the survival rates between the HCC groups, whose optional one marker was over the demarcation level and whose remainders were equal to or less than the demarcation levels and another HCC group whose optional one marker was equal to or less than the demarcation level and whose remainders were over the demarcation levels to reconfirm the weight of each prognostic factor. These comparisons together with Cox's analysis showed that the weight of each prognostic factor in the survival rates is consecutively ordered as DCP, FI, and AFP. The present study indicates that measurements of FI, AFP, and DCP from the sera before the initial treatment improve prognostic estimates and appraisal of the therapeutic outcome in patients with HCC. (C) 2003 Elsevier B.V. All rights reserved.