Prognostic significance of combined α-fetoprotein and CA19-9 for hepatocellular carcinoma after hepatectomy
Abstract Background The prognosis of hepatocellular carcinoma (HCC) varies considerably among patients with the same disease stage and characteristics, and only about two thirds show high levels of α-fetoprotein (AFP), a common prognostic indicator for HCC. Here, we assessed whether the combination...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-10-01
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| Series: | World Journal of Surgical Oncology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12957-022-02806-9 |
| _version_ | 1811249893767905280 |
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| author | Jie Zhang Shang Dong Qin Yan Li Fei Lu Wen Feng Gong Jian Hong Zhong Liang Ma Jing Fei Zhao Guo Hua Zhan Peng Zhan Li Bin Song Bang De Xiang |
| author_facet | Jie Zhang Shang Dong Qin Yan Li Fei Lu Wen Feng Gong Jian Hong Zhong Liang Ma Jing Fei Zhao Guo Hua Zhan Peng Zhan Li Bin Song Bang De Xiang |
| author_sort | Jie Zhang |
| collection | DOAJ |
| description | Abstract Background The prognosis of hepatocellular carcinoma (HCC) varies considerably among patients with the same disease stage and characteristics, and only about two thirds show high levels of α-fetoprotein (AFP), a common prognostic indicator for HCC. Here, we assessed whether the combination of presurgical serum levels of AFP and carbohydrate antigen 19-9 (CA19-9) can predict the prognosis of HCC patients after hepatectomy. Methods The clinicopathological characteristics and post-hepatectomy outcomes of 711 HCC patients were retrospectively reviewed. The patients were classified into three groups based on whether their preoperative serum levels of both AFP and CA19-9 were higher than the respective cut-offs of 400 ng/ml and 37 U/ml [double positive (DP)], the level of only one marker was higher than the cut-off [single positive (SP)], or neither level was higher than the cut-off [negative (N)]. The overall survival (OS) and recurrence-free survival (RFS) rates were estimated using Kaplan–Meier curves. Univariate and multivariate survival analyses were performed to identify the clinicopathological factors significantly associated with HCC prognosis. Results The 1-year, 3-year, and 5-year RFS and OS rates in the N group were significantly higher than those in the SP group, while the DP group showed the lowest rates. Multivariate Cox regression analysis showed that large tumor size (> 5 cm), multiple tumors (≥ 2), incomplete tumor capsule, positive microvascular invasion, Barcelona Clinic Liver Cancer C stage, and CA19-9 level > 37 U/mL were independent risk factors for RFS and OS in HCC patients. Moreover, aspartate aminotransferase levels > 40 U/L proved to be an independent prognostic factor for OS. Conclusion The combination of serum AFP and CA19-9 levels may be a useful prognostic marker for HCC patients after hepatectomy. |
| first_indexed | 2024-04-12T15:55:24Z |
| format | Article |
| id | doaj.art-c08e6c47e7f74d70b0caa5aec672316c |
| institution | Directory Open Access Journal |
| issn | 1477-7819 |
| language | English |
| last_indexed | 2024-04-12T15:55:24Z |
| publishDate | 2022-10-01 |
| publisher | BMC |
| record_format | Article |
| series | World Journal of Surgical Oncology |
| spelling | doaj.art-c08e6c47e7f74d70b0caa5aec672316c2022-12-22T03:26:24ZengBMCWorld Journal of Surgical Oncology1477-78192022-10-0120111010.1186/s12957-022-02806-9Prognostic significance of combined α-fetoprotein and CA19-9 for hepatocellular carcinoma after hepatectomyJie Zhang0Shang Dong Qin1Yan Li2Fei Lu3Wen Feng Gong4Jian Hong Zhong5Liang Ma6Jing Fei Zhao7Guo Hua Zhan8Peng Zhan Li9Bin Song10Bang De Xiang11Department of Hepatobiliary Surgery, Guangxi Medical University Cancer HospitalDepartment of Hepatobiliary Surgery, Guangxi Medical University Cancer HospitalDepartment of Hepatobiliary Surgery, Guangxi Medical University Cancer HospitalGuangxi Medical Information InstituteDepartment of Hepatobiliary Surgery, Guangxi Medical University Cancer HospitalDepartment of Hepatobiliary Surgery, Guangxi Medical University Cancer HospitalDepartment of Hepatobiliary Surgery, Guangxi Medical University Cancer HospitalDepartment of Hepatobiliary Surgery, Guangxi Medical University Cancer HospitalDepartment of Hepatobiliary Surgery, Guangxi Medical University Cancer HospitalGuangxi Medical UniversityGuangxi Medical UniversityDepartment of Hepatobiliary Surgery, Guangxi Medical University Cancer HospitalAbstract Background The prognosis of hepatocellular carcinoma (HCC) varies considerably among patients with the same disease stage and characteristics, and only about two thirds show high levels of α-fetoprotein (AFP), a common prognostic indicator for HCC. Here, we assessed whether the combination of presurgical serum levels of AFP and carbohydrate antigen 19-9 (CA19-9) can predict the prognosis of HCC patients after hepatectomy. Methods The clinicopathological characteristics and post-hepatectomy outcomes of 711 HCC patients were retrospectively reviewed. The patients were classified into three groups based on whether their preoperative serum levels of both AFP and CA19-9 were higher than the respective cut-offs of 400 ng/ml and 37 U/ml [double positive (DP)], the level of only one marker was higher than the cut-off [single positive (SP)], or neither level was higher than the cut-off [negative (N)]. The overall survival (OS) and recurrence-free survival (RFS) rates were estimated using Kaplan–Meier curves. Univariate and multivariate survival analyses were performed to identify the clinicopathological factors significantly associated with HCC prognosis. Results The 1-year, 3-year, and 5-year RFS and OS rates in the N group were significantly higher than those in the SP group, while the DP group showed the lowest rates. Multivariate Cox regression analysis showed that large tumor size (> 5 cm), multiple tumors (≥ 2), incomplete tumor capsule, positive microvascular invasion, Barcelona Clinic Liver Cancer C stage, and CA19-9 level > 37 U/mL were independent risk factors for RFS and OS in HCC patients. Moreover, aspartate aminotransferase levels > 40 U/L proved to be an independent prognostic factor for OS. Conclusion The combination of serum AFP and CA19-9 levels may be a useful prognostic marker for HCC patients after hepatectomy.https://doi.org/10.1186/s12957-022-02806-9Hepatocellular carcinomaHepatectomyα-fetoproteinCA19-9Prognosis |
| spellingShingle | Jie Zhang Shang Dong Qin Yan Li Fei Lu Wen Feng Gong Jian Hong Zhong Liang Ma Jing Fei Zhao Guo Hua Zhan Peng Zhan Li Bin Song Bang De Xiang Prognostic significance of combined α-fetoprotein and CA19-9 for hepatocellular carcinoma after hepatectomy World Journal of Surgical Oncology Hepatocellular carcinoma Hepatectomy α-fetoprotein CA19-9 Prognosis |
| title | Prognostic significance of combined α-fetoprotein and CA19-9 for hepatocellular carcinoma after hepatectomy |
| title_full | Prognostic significance of combined α-fetoprotein and CA19-9 for hepatocellular carcinoma after hepatectomy |
| title_fullStr | Prognostic significance of combined α-fetoprotein and CA19-9 for hepatocellular carcinoma after hepatectomy |
| title_full_unstemmed | Prognostic significance of combined α-fetoprotein and CA19-9 for hepatocellular carcinoma after hepatectomy |
| title_short | Prognostic significance of combined α-fetoprotein and CA19-9 for hepatocellular carcinoma after hepatectomy |
| title_sort | prognostic significance of combined α fetoprotein and ca19 9 for hepatocellular carcinoma after hepatectomy |
| topic | Hepatocellular carcinoma Hepatectomy α-fetoprotein CA19-9 Prognosis |
| url | https://doi.org/10.1186/s12957-022-02806-9 |
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