术前甲胎蛋白评估预后的意义 乙肝相关肝癌

StephenW

Ann Surg Oncol. <http://www.ncbi.nlm.nih.gov/pubmed/24232510&gt; 2013 Nov
14. [Epub ahead of print]

Assessing Prognostic Significance of Preoperative Alpha-Fetoprotein in
Hepatitis B-Associated Hepatocellular Carcinoma: Normal is not the New
Normal.

Blank S
<http://cirrus.mail-list.com/hepatitis-b/99168469.html&gt;, Wang Q
<http://cirrus.mail-list.com/hepatitis-b/25989089.html&gt;, Fiel MI
<http://cirrus.mail-list.com/hepatitis-b/27445181.html&gt;, Luan W
<http://cirrus.mail-list.com/hepatitis-b/79562610.html&gt;, Kim KW
<http://cirrus.mail-list.com/hepatitis-b/20641433.html&gt;, Kadri H
<http://cirrus.mail-list.com/hepatitis-b/98573824.html&gt;, Mandeli J
<http://cirrus.mail-list.com/hepatitis-b/60918996.html&gt;, Hiotis SP
<http://cirrus.mail-list.com/hepatitis-b/96724771.html&gt;.

Source: http://www.ncbi.nlm.nih.gov/pubmed/24232510

Division of Surgical Oncology, Department of Surgery, The Mount Sinai
Medical Center, Mount Sinai School of Medicine, New York, NY, USA.

Abstract

BACKGROUND:

Hepatitis B(HBV)-associated hepatocellular carcinoma (HCC) is often
associated with alpha-fetoprotein (AFP) production. Although serum AFP
has been demonstrated to be a prognostic factor for patient survival,
optimal cutoff levels remain unclear.

METHODS:

Patients with HBV-associated HCC treated by primary liver resection were
prospectively followed at a single institution between 1995 and 2008. AFP
level was categorized into quintiles for Kaplan-Meier analysis and
multivariable Cox proportional hazards regression models.

RESULTS:

Best 5-year survival after surgery was observed for patients with AFP in
the first quintile (1.4-4.1 ng/mL), with progressively worse outcomes for
patients in each increasing quintile. AFP was associated with overall
survival (HR = 1.61; 95 % CI 1.30-1.98), disease-free survival (HR =
1.26; 95 % CI 1.10-1.44), and 2-year recurrence (HR = 1.30; 95 % CI
1.07-1.57) in multivariate analysis. Noncirrhotic patients (Ishak 1-5)
with AFP in quintile 1 had 94 % 5-year survival, compared with 0 %
survival for patients with AFP in quintile 5 (2,332.7-327,560.0 ng/mL)
and Ishak stage 6 cirrhosis.

CONCLUSIONS:

Preoperative serum AFP is an independent predictor of prognosis among
HBV-HCC patients following surgical resection. Categorizing AFP into
quintiles creates the opportunity to observe differences in outcomes even
at low serum levels within the normal range. Additionally, combining AFP
quintiles and fibrosis staging provides a predictive model of prognosis
for HCC. Thus, even small differences in AFP within the normal range may
impact prognosis and disease progression for HBV-HCC.

StephenW

安外科肿瘤学。中<http://www.ncbi.nlm.nih.gov/pubmed/24232510> 11月2013日
14。 [ EPUB的提前打印]

术前甲胎蛋白评估预后的意义
乙肝相关肝癌： “正常”是不是新
正常。

空白Ş
<http://cirrus.mail-list.com/hepatitis-b/99168469.html> ，王琪
<http://cirrus.mail-list.com/hepatitis-b/25989089.html> ，感受MI
<http://cirrus.mail-list.com/hepatitis-b/27445181.html> ，栾W
<http://cirrus.mail-list.com/hepatitis-b/79562610.html> ，金KW
<http://cirrus.mail-list.com/hepatitis-b/20641433.html> ，卡德里ħ
<http://cirrus.mail-list.com/hepatitis-b/98573824.html> Mandeli Ĵ
<http://cirrus.mail-list.com/hepatitis-b/60918996.html> Hiotis SP
<http://cirrus.mail-list.com/hepatitis-b/96724771.html> 。

资料来源： http://www.ncbi.nlm.nih.gov/pubmed/24232510

肿瘤外科，外科部，西奈山
医疗中心，西奈山医学院，纽约， NY ， USA 。

抽象

背景：

乙肝病毒（HBV ）相关的肝细胞癌（HCC ）是经常
甲胎蛋白（ AFP ）的生产相关。虽然血清AFP
已被证明是一个病人生存预后因素，
最佳临界水平仍不清楚。

方法：

乙肝相关性肝癌患者治疗原发性肝切除的
前瞻性随访了1995年和2008年间，在一个单一的机构。法新社
分为水平的五分之一人口的Kaplan-Meier分析
多因素Cox比例风险回归模型。

结果：

最好的5年生存率在观察手术后患者的AFP
第一次的五分之一（ 1.4-4.1纳克/毫升） ，与逐步恶化的结果
患者每增加五分之一。 AFP是与整体
生存期（ HR = 1.61 ，95％ CI为1.30-1.98 ） ，无病生存率（HR =
1.26 ，95％CI ,1.10-1 .44 ） ， 2年复发（ HR = 1.30 ，95％CI
1.07-1.57 ） ，多变量分析。肝硬化的患者（伊沙克1-5 ）
AFP五分之一1比0％ ， 94 ％， 5年生存率
生存五分之一5 （ 2,332.7-327,560.0毫微克/毫升的患者AFP ）
伊沙克阶段6肝硬化。

结论：

术前血清AFP是预后的独立预测因子之间
HBV -肝癌手术切除后的患者。分类AFP成
昆泰公司创造了机会，甚至观察结果差异
在低血清水平在正常范围内。此外，结合AFP
昆泰公司和纤维化分期提供预后预测模型
肝癌。因此，即使是小的差异，在AFP在正常范围内，可
HBV - HCC影响预后和病情恶化。
VR影响亚洲可控硅以外的因素。