Prognostic value of α-fetoprotein and des-γ-carboxy prothrombin responses in patients with hepatocellular carcinoma treated with transarterial chemoembolization

BMC Cancer

Research Article

Yong Kang Lee¹  Do Young Kim²  Chae Yoon Chon²  Seung Up Kim²  Jun Yong Park²  Sang Hoon Ahn³  Kwang-Hyub Han³  Kwang Hun Lee⁴  Do Yun Lee⁴ 

[1] Department of Internal Medicine, Yonsei University College of Medicine, 250 Seongsanno, 120-752, Seodaemun–gu, Seoul, South Korea;Department of Internal Medicine, Yonsei University College of Medicine, 250 Seongsanno, 120-752, Seodaemun–gu, Seoul, South Korea;Liver Cancer Special Clinic, Yonsei University College of Medicine, Seoul, South Korea;Liver Cirrhosis Clinical Research Center, Seoul, South Korea;Department of Internal Medicine, Yonsei University College of Medicine, 250 Seongsanno, 120-752, Seodaemun–gu, Seoul, South Korea;Liver Cancer Special Clinic, Yonsei University College of Medicine, Seoul, South Korea;Liver Cirrhosis Clinical Research Center, Seoul, South Korea;Brain Korea 21 Project for Medical Science, Seoul, South Korea;Department of Radiology, Yonsei University College of Medicine, Seoul, South Korea;Liver Cancer Special Clinic, Yonsei University College of Medicine, Seoul, South Korea;Liver Cirrhosis Clinical Research Center, Seoul, South Korea;

关键词: Alpha-fetoprotein;    Des gamma carboxy prothrombin;    Transarterial chemoembolization;    Tumor marker response;    Hepatocellular carcinoma;    Prognosis;    Survival;   

DOI  :  10.1186/1471-2407-13-5

 received in 2012-04-02, accepted in 2012-11-26,  发布年份 2013

来源: Springer

【 摘 要 】

Background/AimsAlpha-fetoprotein (AFP) and des-gamma-carboxy prothrombin (DCP) have been used as diagnostic tools for hepatocellular carcinoma (HCC). However, prediction of outcome using AFP and DCP has not been elucidated. We investigated the clinical role of AFP and DCP as predictors of treatment outcome in patients with HCC undergoing trans-arterial chemoembolization (TACE).MethodsBetween January 2003 and December 2005, we enrolled 115 treatment-naïve patients who received TACE as an initial treatment modality. An AFP or DCP response was defined as a reduction of more than 50% from the baseline level 1 month after TACE. Patients with AFP < 20 ng/mL or DCP < 20 mAU/mL were excluded.ResultsThe median age was 59 years and the male gender predominated (n = 81, 70.4%). AFP and DCP response was identified in 91 (79.1%) and 77 (66.9%) patients after TACE. Although progression-free survival (PFS) did not differ according to AFP response (P = 0.150), AFP responders showed significantly better overall survival (OS) than non-responders (34.9 vs. 13.2 months; P = 0.002). In contrast, DCP response did not influence either PFS or OS (all P > 0.05). Multivariate analyses showed that gamma-glutamyltranspeptidase and baseline AFP were predictors of PFS (all P < 0.05) and that male gender, the presence of liver cirrhosis, baseline DCP, number of measurable tumors and AFP response were independent predictors of OS (all P < 0.05).ConclusionsAFP response and higher baseline DCP level are significant predictors of OS in treatment-naïve patients with HCC receiving TACE who showed pretreatment elevation of both AFP and DCP.

【 授权许可】

Unknown   
© Lee et al.; licensee BioMed Central Ltd. 2013. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.