title: Low P2/MS value is an independent risk factor for early recurrence of hepatocellular carcinoma after radiofrequency ablation therapy.
abstract: OBJECTIVE
  The influence of liver fibrosis on the recurrence of hepatocellular carcinoma after ablation therapy has not been fully elucidated. We previously reported that P2/MS [(platelet count [10(9)/L])2/(monocyte fraction[%] x segmented neutrophil fraction[%])] is an effective and noninvasive marker reflecting the degree of hepatic fibrosis. We aimed to evaluate the relationship between P2/MS value and hepatocellular carcinoma recurrence after radiofrequency ablation therapy in this study.
  
  
  METHODS
  Chronic hepatitis B patients who underwent RFA for hypervascular single hepatocellular carcinoma at Seoul National University Hospital between 2004 and 2007 were prospectively included. We identified the predictors of recurrence using Cox-regression model.
  
  
  RESULTS
  Fifty one patients were included. Median follow-up duration was 14.2 months. Twenty patients experienced tumor recurrence. Multivariable analyses showed that low P2/MS level [HR, 0.97 (95% CI, 0.95-0.99); p = 0.008] and alpha-fetoprotein level >100 ng/mL [HR, 8.65 (95% CI, 2.37-31.67); p = 0.001] were independent risk factors for tumor recurrence. Patients with P2/MS < 45.0 showed 3.68-fold (p = 0.048) increase in the risk of recurrence compared to those with P2/MS > or =45.0. However, tumor size, HBeAg and HBV DNA level failed to significantly affect the time-to-recurrence.
  
  
  CONCLUSIONS
  Our study suggests that low P2/MS value, which indicates high grade of hepatic fibrosis, is an independent risk factor for HBV-related hepatocellular carcinoma recurrence after radiofrequency ablation.
authors.affiliation: Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Min-Sun
authors.initials: MS
authors.lastname: Kwak
authors.forename: Jeong-Hoon
authors.initials: JH
authors.lastname: Lee
authors.forename: Goh Eun
authors.initials: GE
authors.lastname: Chung
authors.forename: Su Jong
authors.initials: SJ
authors.lastname: Yu
authors.forename: Eun Uk
authors.initials: EU
authors.lastname: Jung
authors.forename: Bo Hyun
authors.initials: BH
authors.lastname: Kim
authors.forename: Dae Hee
authors.initials: DH
authors.lastname: Choi
authors.forename: Hwi Young
authors.initials: HY
authors.lastname: Kim
authors.forename: Se Hyung
authors.initials: SH
authors.lastname: Kim
authors.forename: Jeong Min
authors.initials: JM
authors.lastname: Lee
authors.forename: Jae Young
authors.initials: JY
authors.lastname: Lee
authors.forename: Yoon Jun
authors.initials: YJ
authors.lastname: Kim
authors.forename: Jung-Hwan
authors.initials: JH
authors.lastname: Yoon
authors.forename: Hyo-Suk
authors.initials: HS
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000097:blood* / Q000601:surgery* / Q000821:virology; D017115:Catheter Ablation; D005260:Female; D019694:Hepatitis B, Chronic / Q000150:complications; D006801:Humans; D007958:Leukocyte Count; D008113:Liver Neoplasms / Q000097:blood* / Q000601:surgery* / Q000821:virology; D008297:Male; D008875:Middle Aged; D009000:Monocytes; D009364:Neoplasm Recurrence, Local / Q000097:blood*; D010976:Platelet Count; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D014408:Biomarkers, Tumor