Des-gamma-carboxy prothrombin and alpha-fetoprotein positive status as a new prognostic indicator after hepatic resection for hepatocellular carcinoma.
BACKGROUND
The aim of this study was to elucidate the usefulness of measuring the positive status of both des-gamma-carboxy prothrombin (DCP) and alpha-fetoprotein (AFP) preoperatively as a new prognostic indicator of hepatocellular carcinoma (HCC).


METHODS
One hundred forty-seven patients who underwent curative hepatic resection for primary HCC were studied. The definitions of DCP and AFP positivity were: positive DCP > 0.1 AU/ml, and positive AFP > 50 ng/ml. The patients were classified into four groups according to their levels of positivity for DCP and/or AFP: Group 1 (n = 59), negative levels of both DCP and AFP; Group 2 (n = 28), negative DCP and positive AFP levels; Group 3 (n = 31), positive DCP and negative AFP levels; and Group 4 (n = 29), positive levels of both DCP and AFP.


RESULTS
Patient survival and disease free survival in Group 4 were the worst among the four groups. By multivariate analysis, using Cox proportional hazards model, both the DCP- and AFP-positive status (in combination) and poorly differentiated histology were independent factors of poor prognosis for patient survival; and DCP- and AFP-positive status (in combination), poorly differentiated histology, positive intrahepatic metastasis, and tumor diameter over 5 cm were independent factors of poor prognosis for disease free survival.


CONCLUSIONS
The combination of DCP- and AFP-positive status is a new prognostic indicator for patients with HCC after hepatic resection.
Shimada
M
M
Department of Surgery II, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Takenaka
K
K
Fujiwara
Y
Y
Gion
T
T
Kajiyama
K
K
Maeda
T
T
Shirabe
K
K
Sugimachi
K
K
D000328:Adult; D000368:Aged; D015415:Biomarkers; D014408:Biomarkers, Tumor / Q000032:analysis*; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D011498:Protein Precursors; D011516:Prothrombin / Q000031:analogs & derivatives* / Q000032:analysis; D015996:Survival Rate; D000509:alpha-Fetoproteins / Q000032:analysis*
D015415:Biomarkers; D014408:Biomarkers, Tumor; D011498:Protein Precursors; D000509:alpha-Fetoproteins; C008208:acarboxyprothrombin; D011516:Prothrombin