A new prognostic scoring system involving des-gamma-carboxy prothrombin as a useful marker for predicting prognosis in patients with hepatocellular carcinoma.
A staging system for hepatocellular carcinoma was reported from Italy (CLIP). In this study, we evaluate the CLIP scoring system and establish a new scoring system for predicting the prognosis of patients with hepatocellular carcinoma. Patients (n=141) who were diagnosed and who underwent initial treatment at our single institution were recruited retrospectively into this study. We evaluated markers for prognosis, using a stratified Cox proportional hazard regression model and Kaplan-Meier survival analysis. CLIP score differentiated patients with different survival experiences by Kaplan-Meier estimated survival analysis. However, with respect the CLIP score, more than two thirds of patients were included in the early stage (CLIP 0-1), and the group with better prognosis than the survival rate of all patients was the only one with CLIP 0. Multivariate analysis revealed that des-gamma-carboxy prothrombin (DCP) >/=100 mAU/ml (relative risk, 2.06; P=0.0218) was statistically significant as a predictor of poor survival. A new prognostic scoring system included DCP classified patients to 6 well-balanced groups (score 0-5). The new prognostic scoring system 0 group (14.9% of the cohort) and the CLIP score 0 group (34.0% of the cohort) had a median survival of 66.9 and 61.6 months. The new prognostic scoring system performs better for prediction of survival than either the CLIP score or the Child-Pugh stage. In conclusion, the described scoring system provides more accurate prognostic information than the CLIP scoring system. It may help physicians decide more appropriate clinical and therapeutic management.
Kawakita
Tomoyuki
T
First Department of Internal Medicine, Mie University School of Medicine, Tsu, Mie 514-8507, Japan.
Shiraki
Katsuya
K
Yamanaka
Yutaka
Y
Yamaguchi
Yumi
Y
Saitou
Yukiko
Y
Enokimura
Naoyuki
N
Yamamoto
Norihiko
N
Okano
Hiroshi
H
Sugimoto
Kazushi
K
Murata
Kazumoto
K
Yamakado
Koichirou
K
Takeda
Kan
K
Nakano
Takeshi
T
D000368:Aged; D015415:Biomarkers; D014408:Biomarkers, Tumor; D006528:Carcinoma, Hepatocellular / Q000145:classification / Q000175:diagnosis*; D002470:Cell Survival; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000145:classification / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D016016:Proportional Hazards Models; D011498:Protein Precursors / Q000494:pharmacology*; D011516:Prothrombin / Q000494:pharmacology*; D013997:Time Factors
D015415:Biomarkers; D014408:Biomarkers, Tumor; D011498:Protein Precursors; C008208:acarboxyprothrombin; D011516:Prothrombin