title: Alpha-1-fucosidase as a prognostic indicator for hepatocellular carcinoma following hepatectomy: a large-scale, long-term study.
abstract: BACKGROUND
  Preoperative alpha-L-fucosidase (AFU) has been used as a diagnostic biomarker for hepatocellular carcinoma (HCC), but its role as a prognostic predictor after partial hepatectomy has not been well defined. The study aimed to investigate the prognostic significance of preoperative serum AFU for HCC patients after hepatic resection.
  
  
  METHODS
  A retrospective training data set and a prospective validation data set were used to evaluate the prognosis of HCC after partial hepatectomy. A total of 669 patients with histopathologically confirmed HCC were enrolled. Univariate and multivariate analyses were used to identify the prognostic significance of preoperative serum AFU.
  
  
  RESULTS
  The retrospective training data set showed a preoperative AFU>35 u l(-1) should be used. The prospective validation data set showed preoperative AFU was an independent prognostic factor of overall survival (OS) (P=0.008; hazard ratio: 2.333; 95% confidence interval: 1.249-4.369). Patients with a preoperative AFU>35 u l(-1) had a lower recurrence-free survival rate and an OS rate than those with AFU≤35 u l(-1), and they have a higher tendency to form macrovascular invasion. Furthermore, the prognostic significance of AFU>35 u l(-1) could also be applied to patients with alpha-fetoprotein levels of ≤400 ng ml(-1).
  
  
  CONCLUSIONS
  Preoperative serum AFU is a prognostic predictor of HCC.
authors.affiliation: Eastern Hepatobiliary Surgery Hospital, The Second Military Medical University, Shanghai, China.
authors.forename: K
authors.initials: K
authors.lastname: Wang
authors.affiliation: Eastern Hepatobiliary Surgery Hospital, The Second Military Medical University, Shanghai, China.
authors.forename: W
authors.initials: W
authors.lastname: Guo
authors.affiliation: Eastern Hepatobiliary Surgery Hospital, The Second Military Medical University, Shanghai, China.
authors.forename: N
authors.initials: N
authors.lastname: Li
authors.affiliation: Eastern Hepatobiliary Surgery Hospital, The Second Military Medical University, Shanghai, China.
authors.forename: J
authors.initials: J
authors.lastname: Shi
authors.affiliation: Eastern Hepatobiliary Surgery Hospital, The Second Military Medical University, Shanghai, China.
authors.forename: C
authors.initials: C
authors.lastname: Zhang
authors.affiliation: 1] Eastern Hepatobiliary Surgery Hospital, The Second Military Medical University, Shanghai, China [2] Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.
authors.forename: W Y
authors.initials: WY
authors.lastname: Lau
authors.affiliation: Eastern Hepatobiliary Surgery Hospital, The Second Military Medical University, Shanghai, China.
authors.forename: M
authors.initials: M
authors.lastname: Wu
authors.affiliation: Eastern Hepatobiliary Surgery Hospital, The Second Military Medical University, Shanghai, China.
authors.forename: S
authors.initials: S
authors.lastname: Cheng
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood*; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D018401:Sample Size; D016019:Survival Analysis; D016896:Treatment Outcome; D054928:Validation Studies as Topic; D005644:alpha-L-Fucosidase / Q000097:blood / Q000502:physiology*
chemical_list: D014408:Biomarkers, Tumor; D005644:alpha-L-Fucosidase