Prognostic significance of combined α-fetoprotein and CA19-9 for hepatocellular carcinoma after hepatectomy

被引:11
作者
Zhang, Jie [1 ]
Qin, Shang Dong [1 ]
Li, Yan [1 ]
Lu, Fei [2 ]
Gong, Wen Feng [1 ]
Zhong, Jian Hong [1 ]
Ma, Liang [1 ]
Zhao, Jing Fei [1 ]
Zhan, Guo Hua [1 ]
Li, Peng Zhan [3 ]
Song, Bin [3 ]
Xiang, Bang De [1 ]
机构
[1] Guangxi Med Univ Canc Hosp, Dept Hepatobiliary Surg, Nanning, Guangxi, Peoples R China
[2] Guangxi Med Informat Inst, Nanning, Guangxi, Peoples R China
[3] Guangxi Med Univ, Nanning, Guangxi, Peoples R China
基金
中国国家自然科学基金;
关键词
Hepatocellular carcinoma; Hepatectomy; alpha-fetoprotein; CA19-9; Prognosis; CARBOHYDRATE ANTIGEN 19-9; CA-19-9;
D O I
10.1186/s12957-022-02806-9
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background: The prognosis of hepatocellular carcinoma (HCC) varies considerably among patients with the same disease stage and characteristics, and only about two thirds show high levels of alpha-fetoprotein (AFP), a common prognostic indicator for HCC. Here, we assessed whether the combination of presurgical serum levels of AFP and carbohydrate antigen 19-9 (CA19-9) can predict the prognosis of HCC patients after hepatectomy. Methods: The clinicopathological characteristics and post-hepatectomy outcomes of 711 HCC patients were retrospectively reviewed. The patients were classified into three groups based on whether their preoperative serum levels of both AFP and CA19-9 were higher than the respective cut-offs of 400 ng/ml and 37 U/ml [double positive (DP)], the level of only one marker was higher than the cut-off [single positive (SP)], or neither level was higher than the cut-off [negative (N)]. The overall survival (OS) and recurrence-free survival (RFS) rates were estimated using Kaplan-Meier curves. Univariate and multivariate survival analyses were performed to identify the clinicopathological factors significantly associated with HCC prognosis. Results: The 1-year, 3-year, and 5-year RFS and OS rates in the N group were significantly higher than those in the SP group, while the DP group showed the lowest rates. Multivariate Cox regression analysis showed that large tumor size (> 5 cm), multiple tumors (>= 2), incomplete tumor capsule, positive microvascular invasion, Barcelona Clinic Liver Cancer C stage, and CA19-9 level > 37 U/mL were independent risk factors for RFS and OS in HCC patients. Moreover, aspartate aminotransferase levels > 40 U/L proved to be an independent prognostic factor for OS. Conclusion: The combination of serum AFP and CA19-9 levels may be a useful prognostic marker for HCC patients after hepatectomy.
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页数:10
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