Prognostic implications of preoperative, postoperative, and dynamic changes of alpha-fetoprotein and des-gamma (γ)-carboxy prothrombin expression pattern for hepatocellular carcinoma after hepatic resection: a multicenter observational study.

Autor:	Tang SC; Department of Hepatopancreatobiliary Surgery, The First Clinical Medical College of Fujian Medical University and First Affiliated Hospital of Fujian Medical University, Fuzhou, China.; Department of Hepatopancreatobiliary Surgery, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, China., Wu YY; Department of Hepatic Surgery II, Eastern Hepatobiliary Surgery Hospital, Navy Medical University (Second Military Medical University), Shanghai, China., Lin ZW; Department of Hepatopancreatobiliary Surgery, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, China., Chen QJ; Department of Hepatopancreatobiliary Surgery, The First Clinical Medical College of Fujian Medical University and First Affiliated Hospital of Fujian Medical University, Fuzhou, China.; Department of Hepatopancreatobiliary Surgery, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, China., Luo C; Department of Hepatopancreatobiliary Surgery, The People's Hospital of Zizhong County, Zizhong, China., Li YT; Department of Hepatobiliary Surgery, Zhongshan Hospital of Xiamen University, Xiamen, China., Fu J; Department of Hepatopancreatobiliary Surgery, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, China., Zheng LF; Department of Hepatopancreatobiliary Surgery, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, China., You PH; Bioinformatics Sample Bank, Biobank in Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, China., You S; Department of Hepatopancreatobiliary Surgery, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, China., You WY; Department of Radiation, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, China., Lin KC; Department of Hepatopancreatobiliary Surgery, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, China., Zhou WP; Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Navy Medical University (Second Military Medical University), Shanghai, China., Lin KY; Department of Hepatopancreatobiliary Surgery, The First Clinical Medical College of Fujian Medical University and First Affiliated Hospital of Fujian Medical University, Fuzhou, China.; Department of Hepatopancreatobiliary Surgery, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, China., Zeng YY; Department of Hepatopancreatobiliary Surgery, The First Clinical Medical College of Fujian Medical University and First Affiliated Hospital of Fujian Medical University, Fuzhou, China.; Department of Hepatopancreatobiliary Surgery, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, China.
Jazyk:	angličtina
Zdroj:	Frontiers in oncology [Front Oncol] 2024 Jun 05; Vol. 14, pp. 1425292. Date of Electronic Publication: 2024 Jun 05 (Print Publication: 2024).
DOI:	10.3389/fonc.2024.1425292
Abstrakt:	Background: The utility of pre- and post-operative alpha-fetoprotein (AFP) and des-gamma (γ)-carboxy prothrombin (DCP) expression patterns and their dynamic changes as predictors of the outcome of hepatic resection for hepatocellular carcinoma (HCC) has yet to be well elucidated. Methods: From a multicenter database, AFP and DCP data during the week prior to surgery and the first post-discharge outpatient visit (within 1-2 months after surgery) were collected from patients with HCC who underwent hepatectomy. AFP-DCP expression patterns were categorized according to the number of positive tumor markers (AFP ≥ 20ng/mL, DCP ≥ 40mAU/mL), including double-negative, single-positive, and double-positive. Changes in the AFP-DCP expression patterns were delineated based on variations in the number of positive tumor markers when comparing pre- and post-operative patterns. Results: Preoperatively, 53 patients (8.3%), 337 patients (52.8%), and 248 patients (38.9%) exhibited double-negative, single-positive, and double-positive AFP-DCP expression patterns, respectively. Postoperatively, 463 patients (72.6%), 130 patients (20.4%), and 45 patients (7.0%) showed double-negative, single-positive, and double-positive AFP-DCP expression patterns, respectively. Survival analysis showed a progressive decrease in recurrence-free (RFS) and overall survival (OS) as the number of postoperative positive tumor markers increased (both P < 0.001). Multivariate analysis showed that postoperative AFP-DCP expression pattern, but not preoperative AFP-DCP expression pattern, was an independent risk factor for RFS and OS. Further analysis showed that for patients with positive preoperative markers, prognosis gradually improves as positive markers decrease postoperatively. In particular, when all postoperative markers turned negative, the prognosis was consistent with that of preoperative double-negative patients, regardless of the initial number of positive markers. Conclusions: AFP-DCP expression patterns, particularly postoperative patterns, serve as vital sources of information for prognostic evaluation following hepatectomy for HCC. Moreover, changes in AFP-DCP expression patterns from pre- to post-operation enable dynamic prognostic risk stratification postoperatively, aiding the development of individualized follow-up strategies. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2024 Tang, Wu, Lin, Chen, Luo, Li, Fu, Zheng, You, You, You, Lin, Zhou, Lin and Zeng.)
Databáze:	MEDLINE
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