Prognostic roles of preoperative &alpha;-fetoprotein and des-&gamma;-carboxy prothrombin in hepatocellular carcinoma patients

doi:10.3748/wjg.v21.i16.4933

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World Journal of Gastroenterology

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1007-9327

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World J Gastroenterol. Apr 28, 2015; 21(16): 4933-4945
Published online Apr 28, 2015. doi: 10.3748/wjg.v21.i16.4933

Prognostic roles of preoperative α-fetoprotein and des-γ-carboxy prothrombin in hepatocellular carcinoma patients

Makoto Meguro, Toru Mizuguchi, Toshihiko Nishidate, Kenji Okita, Masayuki Ishii, Shigenori Ota, Tomomi Ueki, Emi Akizuki, Koichi Hirata

Makoto Meguro, Toru Mizuguchi, Toshihiko Nishidate, Kenji Okita, Masayuki Ishii, Shigenori Ota, Tomomi Ueki, Emi Akizuki, Koichi Hirata, Department of Surgery, Surgical Oncology and Science, Sapporo Medical University School of Medicine, Chuo-ku, Sapporo, Hokkaido 060-8543, Japan

Author contributions: Meguro M and Mizuguchi T contributed equally to this work; Meguro M and Mizuguchi T design this study, analyzed, interpreted and drafted the manuscript; Meguro M and Mizuguchi T, Nishidate T, Okita K, Ishii M, Ota S, Ueki T and Akizuki E acquire the data; Mizuguchi T and Hirata K contributed to statistical advice.

Supported by Grant-in-Aid for Scientific Research from the Ministry of Education, Culture, Sports, Science and Technology, Japan, [Grant No. 24791437 and No. 26461920 (to Meguro M), No. 13377023 (to Hirata K), and No. 23591993 (to Mizuguchi T)]; A grant from the Yuasa Memorial Foundation was awarded to Mizuguchi T.

Ethics approval: The study was reviewed and approved by the institutional review boards of the Sapporo Medical University.

Informed consent: The study design conformed to the ethical guidelines of the Declaration of Helsinki, and all study participants, or their legal guardian, provided informed written consent prior to study enrollment.

Conflict-of-interest: There are no conflict-of-interests for all co-authors.

Data sharing: No additional data are available.

Correspondence to: Makoto Meguro, MD, PhD, Department of Surgery, Surgical Oncology and Science, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, Hokkaido 060-8543, Japan. meguro@sapmed.ac.jp

Telephone: +81-11-6112111 Fax: +81-11-6131678

Received: September 30, 2014
Peer-review started: September 30, 2014
First decision: October 29, 2014
Revised: November 11, 2014
Accepted: December 14, 2014
Article in press: December 16, 2014
Published online: April 28, 2015
Processing time: 209 Days and 2.3 Hours

Core Tip

Core tip: There is no consensus regarding using cutoff levels of tumor markers to predict survival and recurrence after hepatectomy for hepatocellular carcinoma. Furthermore, the prognostic characteristics of these tumor markers according to hepatitis type remain unclear. The α-fetoprotein (AFP) cutoff level for recurrence within 2 years after surgery was 21.0 ng/mL in the hepatitis C virus (HCV) group compared with 529.8 ng/mL in the hepatitis B virus (HBV) group. Furthermore, patients in the HBV group with high levels of either AFP or des-γ-carboxy prothrombin (DCP) had poor prognoses, as did those patients with high levels of both tumor markers. In contrast, only those patients in the HCV group who had high levels of both AFP and DCP had poor prognoses. We believe that to predict prognosis, preoperative levels of tumor markers should be distinguished and assessed according to the type of viral hepatitis.