Significance of Alpha-Fetoprotein and Des-γ-Carboxy Prothrombin in Patients with Hepatocellular Carcinoma Undergoing Hepatectomy

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• 作者：Kentaroh Yamamoto MD (1)
  Hiroshi Imamura MD (1)
  Yutaka Matsuyama PhD (2)
  Kiyoshi Hasegawa MD (1)
  Yoshifumi Beck MD (1)
  Yasuhiko Sugawara MD (1)
  Masatoshi Makuuchi MD (1)
  Norihiro Kokudo MD (1)
  
• 刊名：Annals of Surgical Oncology
• 出版年：2009
• 出版时间：October 2009
• 年：2009
• 卷：16
• 期：10
• 页码：2795-2804
• 全文大小：490KB
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• 作者单位：Kentaroh Yamamoto MD (1)
  Hiroshi Imamura MD (1)
  Yutaka Matsuyama PhD (2)
  Kiyoshi Hasegawa MD (1)
  Yoshifumi Beck MD (1)
  Yasuhiko Sugawara MD (1)
  Masatoshi Makuuchi MD (1)
  Norihiro Kokudo MD (1)
  
  1. Department of Surgery, Hepato-Biliary-Pancreatic Surgery Division, Artificial Organ and Transplantation Division, University of Tokyo, Tokyo, Japan
  2. Department of Biostatistics, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
  

文摘

Background Alpha-fetoprotein (AFP) and des-γ-carboxy prothrombin (DCP) are well-known tumor markers of hepatocellular carcinoma (HCC). The aims of this study are to calculate the sensitivity/specificity of AFP and DCP measurement for the diagnosis of HCC, measure response rates of the markers following curative-intent resections, determine the correlations between the marker levels and clinicopathological prognostic variables, and determine the correlations between the marker levels before hepatectomy and those at diagnosis of recurrence. Methods A retrospective cohort study of 714 consecutive patients with HCC undergoing hepatectomy was carried out. Results The areas under the receiver operating characteristic curves were 0.79 versus 0.91 for AFP and DCP, respectively (P?<?0.001). Positive AFP and DCP status became negative at 6?months post surgery in 184/229 (80.3%) and 245/246 (99.6%) patients, respectively (cutoff values being 20?ng/ml for AFP and 40 mAU/ml for DCP; P?<?0.0001). No correlation was found between marker levels (rs?=?0.23). The level of DCP, but not that of AFP, showed a close correlation with tumor size (rs?=?0.51 and 0.19, respectively). They were associated with indices of tumor invasiveness without showing any specific associations. AFP and DCP levels in patients showing recurrence in???months correlated with the levels measured before surgery (rs?=?0.78 and 0.49, respectively) but not in those showing recurrence after 2?years (rs?=?0.31 and 0.30, respectively). Conclusions DCP is a more accurate, albeit complementary, HCC marker than AFP. While the levels of both markers increased with advancing tumor growth, no specific associations were found. The marker values at recurrence indicated the type of recurrence.