VALUES OF AFP-L3% AND PIVKA-II IN RECURRENCE PROGNOSIS AFTER FOR HEPATOCELLULAR CARCINOMA (HCC)

Abstract

Objectives: The prognosis of recurrence after hepatectomy in HCC is still difficult. The association between image studies (CT, MRI) with AFP-L3 and PIVKA-II is now proved of interest. This study is to determine the values of these 2 new tumor markers in predicting the recurrence risk of HCC after liver resection.

Methods: Prospective cohort study in 104 HCC patients who were operated and followed up to deaths or 2 years. The tumor markers were preoperatively measured and the recurrences were diagnosed by CT, MRI or biopsy. Data were estimated by SPSS 20.0 and analyzed with Receiver operating characteristic (ROC) curves to determine the predictive value of tumor markers, and Kaplan-Meier survival curves and Log-rank test to find the relationships between DFS and OS and level of tumor markers (p value <0.05 is statistically significant).

Results: The values of tumor markers in recurrence and survival prognosis were: Preoperative threshold of AFP-L3% was 13.6%, (sensitivity: 59.26%, specificity: 70%, AUC=0.636, p=0.017). Preoperative threshold of PIVKA-II was 903 mAU/ml, (sensitivity: 79.6%, specificity: 62%, AUC=0.703, p=0.000355). High Levels of preoperative AFP-L3% and PIVKA-II were significantly related with recurrence and survival after operation (p <0.005). Association between 3 tumor markers (AFP-L3%, PIVKA-II and AFP): patients who had the more numbers of preoperative tumor markers higher than valuable thresholds the worse their prognoses were.

Conclusions: Valuable thresholds of preoperative AFP-L3% and PIVKA-II in recurrence and survival prognosis were 13.6% and 903 mAU/ml.

Keywords: AFP-L3%, PIVKA-II, recurrence and survival after hepatectomy for HCC