Higher Ratio of Serum Alpha-Fetoprotein Could Predict Outcomes in Patients with Hepatitis B Virus-Associated Hepatocellular Carcinoma and Normal Alanine Aminotransferase.
Higher Ratio of Serum Alpha-Fetoprotein Could Predict Outcomes in Patients with Hepatitis B Virus-Associated Hepatocellular Carcinoma and Normal Alanine Aminotransferase.
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DOI：
10.1371/journal.pone.0157299
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发表时间：
2016
期刊：
影响因子：
3.7
通讯作者：
Park JW
中科院分区：
文献类型：
--
作者：
Kim YI;Kim HS;Park JW
血清甲胎蛋白（AFP）水平在肝细胞癌（HCC）监测和诊断中的作用存在争议。本研究的目的是探讨连续测量血清AFP水平在HCC进展或初始治疗后复发中的价值。在2004年1月至2009年12月期间，共有722名新诊断为HCC并在韩国国家癌症中心接受治疗的连续患者入选。获得治疗后4-8周与HCC进展或复发时的AFP比值。进行多因素logistic回归分析，以将治疗后AFP比值与HCC进展或复发的存在相关联。肝细胞癌的病因与慢性B型肝炎病毒（HBV）感染有关562例（77.8%），与慢性丙型肝炎病毒（HCV）感染有关74例（10.2%），与非病毒感染有关86例（11.9%）。从基线到治疗后4至8周，血清AFP水平显著降低（AFP中位数，319.6 ng/mL vs. 49.6 ng/mL; p< 0.001）。多因素分析显示AFP比值> 1.0与HCC进展或复发独立相关。在所分析的不同病因的HCC中，这种关联仅在慢性B型肝炎（p< 0.001）和非病毒病因（p<0.05）相关的HCC中有意义，并且仅限于丙氨酸氨基转移酶（ALT）水平正常的患者。血清AFP比值的系列测量可能有助于检测ALT正常的HBV-HCC治疗患者的进展或复发。
The role of serum alpha-fetoprotein (AFP) levels in the surveillance and diagnosis of hepatocellular carcinoma (HCC) is controversial. The aim of this study was to investigate the value of serially measured serum AFP levels in HCC progression or recurrence after initial treatment. A total of 722 consecutive patients newly diagnosed with HCC and treated at the National Cancer Center, Korea, between January 2004 and December 2009 were enrolled. The AFP ratios between 4–8 weeks post-treatment and those at the time of HCC progression or recurrence were obtained. Multivariate logistic regression analysis was performed to correlate the post-treatment AFP ratios with the presence of HCC progression or recurrence. The etiology of HCC was related to chronic hepatitis B virus (HBV) infection in 562 patients (77.8%), chronic hepatitis C virus (HCV) infection in 74 (10.2%), and non-viral cause in 86 (11.9%). There was a significant decrease in serum AFP levels from the baseline to 4 to 8 weeks after treatment (median AFP, 319.6 ng/mL vs. 49.6 ng/mL; p< 0.001). Multivariate analysis showed that an AFP ratio > 1.0 was an independently associated with HCC progression or recurrence. Among the different causes of HCC analyzed, this association was significant only for HCC related to chronic hepatitis B (p< 0.001) and non-viral causes (p<0.05), and limited only to patients who had normal alanine aminotransferase (ALT) levels. Serial measurements of serum AFP ratios could be helpful in detecting progression or recurrence in treated patients with HBV-HCC and normal ALT.