Value of alpha-foetoprotein for screening of recurrence in hepatocellular carcin

StephenW

Singapore Med J. 2012 Jan;53(1):32-5.
Value of alpha-foetoprotein for screening of recurrence in hepatocellular carcinoma post resection.Chang SK, Hlaing WW, Yu RQ, Lee TW, Ganpathi IS, Madhavan KK.
SourceDivision of Hepatobiliary & Pancreatic Surgery, Department of Surgery, National University Hospital, 1E Kent Ridge Road, NUHS Tower Block, Level 8, Singapore 119228.        [email protected].

AbstractIntroduction: The aim of this study was to establish the value of alpha-foetoprotein (AFP) for the screening of recurrences in hepatocellular carcinoma (HCC) in patients who have undergone curative hepatic resection.    Methods: 72 HCC patients who had curative resection/liver transplant in 2000-2006 were monitored for recurrence by evaluating the three- or six-monthly AFP and computed tomography images. Patients without recurrence were followed up for a mean duration of 7.27 years.    Results: Out of the 72 patients, 34 (47.2%) suffered from HCC recurrence. 65.4% of recurrent cases had AFP values showing an upward trend. Patients with recurrence had higher AFP values than those without at last follow-up (119.45 μg/L vs. 3.1 μg/L, p < 0.001). AFP at recurrence was independent of gender, race, history of alcohol consumption and hepatitis C or cirrhosis status. Patient with hepatitis B or those with tumours larger than 5 cm had higher AFP values. The best cut-off AFP indicative of HCC recurrence was 5.45 μg/L (sensitivity 84.4%; specificity 77.1%). High preoperative AFP was associated with high AFP at recurrence (correlation coefficient 0.553, p = 0.01).    Conclusion: AFP alone is an inadequate screening test for HCC recurrence since only about two-thirds of patients showed upward AFP trend on recurrence. Our study found a relatively low cut-off point for detection of recurrence (5.54 μg/L). Patients with high preoperative AFP tended to have high AFP on recurrence. Imaging is recommended for patients with AFP levels > 5.45 μg/L, especially when AFP shows a rising trend.

StephenW

新加坡医学研究2012年1月53（1）:32- 5。
α- foetoprotein值后肝癌切除复发筛查。
张SK，莱第一次世界大战，于RQ，李荃湾，Ganpathi IS，Madhavan先生KK。
来源

肝胆及胰腺外科，外科部，国立大学医院，1E肯特岗路，商业大楼NUHS，8级，新加坡119228部。 [email protected]。
摘要

简介：本研究的目的是要建立谁经历了根治性肝切除术的患者在肝细胞癌（HCC）复发的筛选α- foetoprotein（法新社）价值。方法：72例HCC患者谁曾在2000-2006年根治性切除/肝移植复发监测评估的三个或每半年AFP和计算机断层扫描图像。术后随访无复发的平均时间为7.27年。结果：72例患者中，有34（47.2％）患有肝癌复发。复发病例的65.4％，AFP值呈上升趋势。没有最后的后续（119.45微克/升和3.1微克/升，P<0.001），复发患者比那些AFP值较高。AFP在复发是独立于性别，种族，历史食用酒精和丙型肝炎或肝硬化的地位。与B型肝炎或肿瘤大于5厘米的患者有较高的AFP值。最好的切断AFP对肝癌复发的指示为5.45微克/升（敏感性84.4％，特异性77.1％）。高术前甲胎蛋白与高复发AFP
（相关系数为0.553，P = 0.01）。结论：AFP仅是HCC复发的不足，筛选试验，因为只有约三分之二的患者呈上升AFP对复发的趋势。我们的研究发现一个相对较低的检测复发（5.54微克/升）的分界点。高术前AFP患者往往有高复发法新社。成像建议患者AFP水平>5.45微克/升，尤其是当AFP显示有上升的趋势。

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