title: Correlation analysis of preoperative serum alpha-fetoprotein (AFP) level and prognosis of hepatocellular carcinoma (HCC) after hepatectomy.
abstract: BACKGROUND
  To investigate the prediction value of preoperative serum alpha-fetoprotein (AFP) level for the prognosis of hepatocellular carcinoma (HCC), by comparing pathological characteristics, recurrence rate and survival rate after hepatectomy.
  
  
  METHODS
  108 cases of HCC patients who received liver resection in our hospital from 2005 to 2011 were enrolled in this study. According to preoperative serum AFP level, the patients were divided into AFP ≤ 20 ng/mL group, AFP 20 to 400 ng/mL group and AFP > 400 ng/mL group, and the clinicopathological and cytopathological features were compared. All the patients were followed up for 24 months, the postoperative recurrence rates and survival rates were compared and analyzed, and the risk factors for HCC postoperative survival rate were studied by multifactor regression analysis.
  
  
  RESULTS
  Of the 108 cases of HCC patients, there were 42 cases in AFP ≤20 ng/mL group, 28 cases in AFP 20-400 ng/mL group and 39 cases in AFP > 400 ng/mL group. It was shown that cell differentiation degrees (χ² = 20.198, P = 0.000) and microvascular invasion rates (χ² = 20.358, P = 0.000) were significantly different among the three groups. The AFP ≤ 20 ng/mL group showed higher cell differentiation degrees and significantly lower microvascular invasion rates compared to the other groups (P < 0.05). The follow-up data showed that postoperative 2-year recurrence rate (χ² = 6.164, P = 0.046), 18-month survival rate (χ² = 7.647, P = 0.022) and 24-month survival rate (χ² = 6.725, P = 0.035) of the three groups were significantly different, and we found that the AFP ≤ 20 ng/mL group had lower postoperative 2-year recurrence rate, and higher 18-month survival rate and 24-month survival rate than the other two groups (P <0.05). Multiple logistic regression analysis indicated that tumor diameter (≥ 5 cm) and preoperative serum AFP level (> 400 ng/mL) were closely correlated with HCC postoperative survival rate (P <0.05).
  
  
  CONCLUSIONS
  It is shown that preoperative serum AFP level has considerable predictive value for the malignant feature and prognosis of HCC. It is suggested that HCC patients with no contraindication of operation and serum AFP ≤ 20 ng/mL can benefit most from primary treatment of hepatectomy. While HCC patients with serum AFP higher than 20 ng/mL need comprehensive therapy besides surgical resection and close follow up.
authors: Cancer Center, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310003, P,R, China. lsteng@zju.edu.cn.
authors: Wen-jun
authors: WJ
authors: Ma
authors: Hai-yong
authors: HY
authors: Wang
authors: Li-song
authors: LS
authors: Teng
mesh_terms: D014408:Biomarkers, Tumor / Q000097:blood*; D006528:Carcinoma, Hepatocellular / Q000097:blood* / Q000175:diagnosis / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood* / Q000175:diagnosis / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D009367:Neoplasm Staging; D057234:Preoperative Period; D011379:Prognosis; D012307:Risk Factors; D015996:Survival Rate; D000509:alpha-Fetoproteins / Q000032:analysis*
chemical_list: D014408:Biomarkers, Tumor; D000509:alpha-Fetoproteins
references: Cancer. 2004 Aug 15;101(4):796-802
references: 15305412
references: Zhonghua Wai Ke Za Zhi. 2009 Oct 15;47(20):1529-31
references: 20092738
references: Cancer Causes Control. 2012 Mar;23(3):455-62
references: 22258434
references: Aliment Pharmacol Ther. 2007 Nov 1;26(9):1187-94
references: 17944733
references: Hepatol Int. 2008 Mar;2(1):17-30
references: 19669276
references: J Huazhong Univ Sci Technolog Med Sci. 2004;24(6):547-9, 559
references: 15791836
references: J Gastroenterol. 2010 Dec;45(12):1272-82
references: 20625772
references: J Clin Gastroenterol. 2000 Dec;31(4):302-8
references: 11129271
references: Zhonghua Shi Yan He Lin Chuang Bing Du Xue Za Zhi. 2011 Aug;25(4):286-8
references: 22097609
references: World J Gastroenterol. 2011 Nov 7;17(41):4563-71
references: 22147961
references: J Am Coll Surg. 2010 May;210(5):727-34, 735-6
references: 20421039
references: Zhonghua Yi Xue Za Zhi. 2011 Aug 23;91(31):2190-4
references: 22094036
references: J Ayub Med Coll Abbottabad. 2009 Jan-Mar;21(1):72-5
references: 20364746
references: Dig Dis Sci. 2009 Jun;54(6):1337-46
references: 19242792
references: Anticancer Res. 2011 Feb;31(2):687-91
references: 21378357
references: J Gastroenterol Hepatol. 1999 May;14 Suppl:S32-6
references: 10382636
references: World J Gastroenterol. 2002 Apr;8(2):193-9
references: 11925590
references: Hepatol Res. 2011 Nov;41(11):1036-45
references: 21883741
references: Korean J Gastroenterol. 2004 Apr;43(4):252-9
references: 15100489
references: Cancer Biomark. 2007;3(2):79-87
references: 17522429
references: J Clin Oncol. 2009 Jan 20;27(3):446-52
references: 19064965
references: Singapore Med J. 2012 Jan;53(1):32-5
references: 22252180
references: Hepatobiliary Pancreat Dis Int. 2005 Feb;4(1):46-9
references: 15730918
references: J Gastrointest Surg. 2005 May-Jun;9(5):638-45
references: 15862257