Reappraisal of the Role of Alkaline Phosphatase in Hepatocellular Carcinoma

被引:25
作者
Huang, Chun-Wei [1 ,2 ]
Wu, Tsung-Han [3 ]
Hsu, Heng-Yuan [1 ,2 ]
Pan, Kuang-Tse [4 ]
Lee, Chao-Wei [3 ]
Chong, Sio-Wai [1 ,2 ]
Huang, Song-Fong [1 ,2 ]
Lin, Sey-En [5 ]
Yu, Ming-Chin [1 ,2 ]
Chen, Shen-Ming [6 ]
机构
[1] New Taipei Municipal Tucheng Hosp, Div Gen Surg, Dept Surg, Chang Gung Med Fdn, New Taipei 23652, Taiwan
[2] Chang Gung Univ & Shen Ming Chen, New Taipei 23652, Taiwan
[3] Linkou & Chang Gung Univ, Chang Gung Mem Hosp, Dept Surg, Taoyuan 33305, Taiwan
[4] Linkou Chang Gung Mem Hosp, Dept Med Imaging & Intervent, Taoyuan 33305, Taiwan
[5] New Taipei Municipal Tucheng Hosp, Dept Pathol, New Taipei 23652, Taiwan
[6] Natl Taipei Univ Technol, Dept Chem Engn & Biotechnol, Taipei 106, Taiwan
关键词
hepatocellular carcinoma; alkaline phosphatase; liver regeneration; RESECTION;
D O I
10.3390/jpm12040518
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Background: Alkaline phosphatase (ALP) is a marker of liver function and is associated with biliary tract disease. It was reported as a prognostic factor for hepatocellular carcinoma (HCC). The genetic expression in tumor-tissue microarrays and the perioperative serologic changes in ALP have never been studied for their correlation with HCC prognosis. Methods: The genetic expression of ALP isoforms (placental (ALPP), intestinal (ALPI) and bone/kidney/liver (ALPL)) was analyzed in tumor and non-cancerous areas in 38 patients with HCC after partial hepatectomy. The perioperative change in ALP was further analyzed in a cohort containing 525 patients with HCC to correlate it with oncologic outcomes. A total of 43 HCC patients were enrolled for a volumetry study after major and minor hepatectomy. Results: The genetic expression of the bone/kidney/liver isoform was specifically and significantly higher in non-cancerous areas than in tumors. Patients with HCC with a higher ALP (>81 U/dL) had significantly more major hepatectomies, vascular invasion, and recurrence. Cox regression analysis showed that gender, major hepatectomies, the presence of satellite lesions, higher grades (III or IV) and perioperative changes in liver function tests were independent prognostic factors for recurrence-free survival, and a postoperative increase in the ALP ratio at postoperative day (POD) 7 vs. POD 0 > 1.46 should be emphasized. A liver regeneration rate more than 1.8 and correlation analysis revealed that the ALP level at POD 7 and 30 was significantly higher and correlated with remnant liver growth. Conclusions: This study demonstrated that the perioperative ALP change was an independent prognostic factor for HCC after partial hepatectomies, and the elevation of ALP represented a functional biomarker for the liver but not an HCC biomarker. The higher regeneration capacity was possibly associated with the elevation of ALP after operation.
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页数:11
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