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《Chinese Journal of Bases and Clinics in General Surgery》 2014-07
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Value on Survival Prediction of The Changes of AFP and sICAM-1 Before and after Surgical Treatment of Hepatocellular Carcinoma

CHEN Yu;CAO Da-yong;LI Xiao;Department of Hepatobiliary Surgery,Xijing Hospital,The Forth Military Medical University;Department of General Surgery,No.451 Hospital of PLA;  
Objective To study the clinical value of changes of serum α-fetoprotein(AFP) and soluble cell adhesion molecule-1(sICAM-1) levels before and after surgical treatment of primary hepatocellular carcinoma(PHC)as predictors of patient survival.Methods The clinical data and followed-up results of 86 patients with hepatocellular carcinoma,received hepatectomy or radiofrequeney ablation(RFA)in Xijing Hospital and the 451~(st) Hospital of PLA were retrospectivly analyzed.The changes of peripheral blood AFP and sICAM-1 levels in patients before and in 1 month after treatment were observed and all patients were divided into different groups according to the changes in both two markers.Then survival rates of each group were analyzed.Results The patients with AFP20μg/L or sICAM-11000 U/L before treatment had lower tumor recurrence rate and higher survival rate than patients with elevated serum levels of the both markers(AFP:P=0.018,P0.001;sICAM-1:P=0.027,P0.001).The larger tumor,late TNM stage,and higher rate of recurrence were associated with elevated serum levels of the both markers(AFP:P=0.016,P=0.026 and P=0.025;sICAM-1:P0.001,P=0.024 and P=0.032).The better survival situation was closely related with these cases treated with hepatectomy and their levels of both markers were lower than the above cutoff values both before and after treatment,or leves of both markers above the cut-off values returned to within the normal range after treatment(AFP:P=0.006,P=0.001;sICAM-1:P=0.001,P=0.002).The patients who had simultaneous increase of AFP and sICAM-1 after operation showed the worst tumor-free and overall survivals(P=0.007,P0.001).Conclusion To test the changes of serum AFP and sICAM-1 levers in early stage after treatment for patients who received radical resection of hepatocellular carcinoma has good clinical value for monitoring of tumor recurrence and predict prognosis.
【Fund】: 国家自然科学基金青年基金项目资助(项目编号:81201926)~~
【CateGory Index】: R735.7
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