Changes in highly sensitive alpha‐fetoprotein for the prediction of the outcome in patients with hepatocellular carcinoma after hepatectomy

Cancer Medicine

Hidenori Toyoda¹  Takashi Kumada¹  Toshifumi Tada¹  Takanori Ito¹  Atsuyuki Maeda²  Yuji Kaneoka²  Chiaki Kagebayashi³ 

[1] Department of Gastroenterology, Ogaki Municipal Hospital, Ogaki, Japan;Department of Surgery, Ogaki Municipal Hospital, Ogaki, Japan;Wako Life Science Inc., Mountain View, California

关键词: Changes;    hepatectomy;    hepatocellular carcinoma;    highly sensitive measurement of AFP‐L3;    prognosis;    tumor markers;   

DOI  :  10.1002/cam4.218

来源: Wiley

【 摘 要 】

Abstract

We investigated changes in highly sensitive lens culinaris agglutinin A-reactive fraction of alpha-fetoprotein (hsAFP-L3) measured using a novel method and its predictive ability for prognosis in patients with hepatocellular carcinoma (HCC) who underwent curative hepatectomy, comparing to other HCC tumor markers, that is, AFP, des-gamma-carboxy prothrombin (DCP), and AFP-L3 measured with conventional method (cAFP-L3). AFP, DCP, and AFP-L3 including both cAFP-L3 and hsAFP-L3 were measured before and after curative hepatectomy in 187 patients. The percentage of patients with elevated tumor marker levels pre- and postoperatively was compared, and recurrence-free and overall survival rates were analyzed based on changes in tumor markers. The percentages of patients with elevated AFP, DCP, and cAFP-L3 decreased postoperatively. In contrast, the percentage of patients with elevated hsAFP-L3 did not decrease postoperatively. Both recurrence-free and overall survival rates were significantly lower in patients whose tumor marker levels remained elevated postoperatively than patients without tumor marker elevation postoperatively. Recurrence-free and overall survival rates of patients in whom hsAFP-L3 became elevated postoperatively despite normal preoperative hsAFP-L3 levels were significantly lower than those of patients with normal hsAFP-L3 postoperatively, and were similar to those of patients with persistent elevation. Preoperative elevations of AFP, DCP, and cAFP normalized in many patients postoperatively, but not for hsAFP-L3. The elevation of hsAFP-L3 identifies patients with poor prognosis despite the normalization of AFP and DCP.

【 授权许可】

CC BY   
© 2014 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.