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Combined measurement of preoperative α-fetoprotein and des-γ-carboxy prothrombin predicts recurrence after curative resection in patients with hepatitis-B-related hepatocellular carcinoma.

 Young Eun Chon  ;  Gi Hong Choi  ;  Myoung Ha Lee  ;  Seung Up Kim  ;  Do Young Kim  ;  Sang Hoon Ahn  ;  Kyung Sik Kim  ;  in Sub Choi  ;  Kwang-Hyub Han  ;  Chae Yoon Chon  ;  Jun Yong Park 
 INTERNATIONAL JOURNAL OF CANCER, Vol.131(10) : 2332-2341, 2012 
Journal Title
Issue Date
Adult ; Aged ; Biomarkers/metabolism* ; Carcinoma, Hepatocellular/diagnosis* ; Carcinoma, Hepatocellular/mortality ; Carcinoma, Hepatocellular/surgery ; Carcinoma, Hepatocellular/virology ; Female ; Hepatitis B/complications ; Humans ; Liver Neoplasms/diagnosis* ; Liver Neoplasms/mortality ; Liver Neoplasms/surgery ; Liver Neoplasms/virology ; Male ; Middle Aged ; Neoplasm Grading ; Neoplasm Staging ; Prognosis ; Protein Precursors/metabolism* ; Prothrombin/metabolism* ; Recurrence ; alpha-Fetoproteins/metabolism*
hepatocelullar carcinoma ; a-fetoprotein ; des-c carboxy prothrombin ; curative resection ; recurrence
Alpha-fetoprotein (AFP) and des-γ-carboxy prothrombin (DCP) are widely used complementary tumor markers for hepatocellular carcinoma (HCC). In this study, we investigated whether preoperative AFP and DCP levels predict recurrence after curative resection in patients with hepatitis B virus (HBV)-related HCC. Records for 267 patients who were diagnosed with HBV-related HCC and who underwent curative resection for HCC were retrospectively reviewed. Patients were divided into two preoperative groups: pre-op I (AFP ≥ 20 ng/dL and DCP ≥ 40 mAU/mL) and pre-op II (AFP ≥ 20 ng/dL and DCP <40 mAU/mL; AFP <20 ng/dL and DCP ≥ 40 mAU/mL; or AFP <20 ng/dL and DCP <40 mAU/mL). Among 267 patients, 102 (38.2%) patients were classified as pre-op I, whereas the other 165 (61.8%) belonged to pre-op II. During the post-resection follow-up [69.0 (3.0-136.0) months] period, 154 (57.7%) patients developed recurrences [68 (66.7%) patients in pre-op I vs. 86 (52.1%) in pre-op II, p = 0.029]. A multivariate analysis revealed that multiple tumors [hazard ratio (HR), 2.210; 95% confidence interval (CI), 1.185-4.121] and pre-op I (HR: 1.890; 95% CI; 1.080-3.289) were significant predictors for recurrence. Disease-free survival (DFS) was significantly shorter in pre-op I compared to that in pre-op II (20.0 vs. 46.8 months, p = 0.006). Elevated preoperative AFP and DCP levels were associated with a higher recurrence rate and shorter DFS in patients with HBV-related HCC after curative resection. The combined measurement of preoperative AFP and DCP may be a prognostic factor for future recurrence.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Kyung Sik(김경식) ORCID logo https://orcid.org/0000-0001-9498-284X
Kim, Do Young(김도영)
Kim, Seung Up(김승업) ORCID logo https://orcid.org/0000-0002-9658-8050
Park, Jun Yong(박준용) ORCID logo https://orcid.org/0000-0001-6324-2224
Ahn, Sang Hoon(안상훈) ORCID logo https://orcid.org/0000-0002-3629-4624
Lee, Myoung Ha(이명하)
Chon, Young Eun(전영은)
Chon, Chae Yoon(전재윤)
Choi, Gi Hong(최기홍) ORCID logo https://orcid.org/0000-0002-1593-3773
Choi, Jin Sub(최진섭)
Han, Kwang-Hyub(한광협) ORCID logo https://orcid.org/0000-0003-3960-6539
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