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Combining γ-GT, PIVKA-II, and AFP to predict long-term prognosis in patients with hepatocellular carcinoma after
Lin Sun1,2, Meixiu Gu1,2, Jiabin Cai3
1Department of Laboratory Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.
Insights
Hepatocellular carcinoma (HCC) prognosis can be improved using a combination of three biomarkers. The combined use of gamma-glutamyl transferase (γ-GT), PIVKA-II, and alpha-fetoprotein (AFP) accurately predicts early recurrence in HCC patients.
Area of Science:
- Hepatology
- Oncology
- Biomarker Discovery
Background:
- Hepatocellular carcinoma (HCC) presents a significant cancer burden in China, characterized by poor prognosis.
- Current prognostic criteria for HCC are complex and limit routine clinical application.
- Identifying reliable prognostic factors is crucial for improving patient outcomes in HCC.
Purpose of the Study:
- To evaluate the correlation between gamma-glutamyl transferase (γ-GT), PIVKA-II, and alpha-fetoprotein (AFP) levels and long-term survival in HCC patients.
- To assess the predictive value of individual and combined biomarkers for HCC recurrence.
- To explore the potential of these biomarkers in developing novel prediction methods for HCC prognosis.
Main Methods:
- Retrospective analysis of 173 HCC patients who underwent curative resection over a 9-year period.
- Evaluation of individual and combined levels of γ-GT, PIVKA-II, and AFP as prognostic indicators.
- Multivariate analysis to identify independent prognostic factors for HCC recurrence.
Main Results:
- Gamma-glutamyl transferase (γ-GT) was identified as an independent prognostic factor for recurrence.
- Individual prediction rates for early recurrence were 63.5% (γ-GT), 79.4% (PIVKA-II), and 39.7% (AFP).
- The combination of γ-GT, PIVKA-II, and AFP achieved a 95.2% prediction rate for early recurrence.
Conclusions:
- γ-GT, PIVKA-II, and AFP are valuable biomarkers for predicting long-term HCC recurrence.
- The composite indicator of γ-GT, PIVKA-II, and AFP significantly enhances the prediction of early recurrence.
- These biomarkers may facilitate the development of new prediction strategies to improve HCC patient prognosis and necessitate more active treatment approaches.
Abstract:
Hepatocellular carcinoma (HCC) is one of the top five contributors to the cancer burden in China, with a poor prognosis and heavy disability-adjusted life year burden. The criteria used for HCC prognosis are complicated and therefore restricted in routine clinical practice. Multiple factors influence HCC malignancy and progression. In this study, we retrospectively evaluated 173 patients with HCC who underwent curative resection for 9 years to evaluate the correlation of a combination of γ-glutamyl transferase (γ-GT), protein induced by vitamin K absence or antagonist-II (PIVKA-II), and α-fetoprotein (AFP) with the long-term survival of patients with HCC. Multivariate analysis revealed that the γ-GT level was an independent prognostic factor for recurrence. The prediction rate of early recurrence with γ-GT, PIVKA-II, and AFP levels individually was 63.5%, 79.4%, and 39.7%, respectively, whereas the prediction rate of early recurrence was 95.2% with the combination of γ-GT, PIVKA-II, and AFP levels as a composite indicator. Our long-term retrospective study revealed that γ-GT, PIVKA-II, and AFP can aid in predicting long-term prognosis of HCC recurrence. The combination of γ-GT, PIVKA-II, and AFP can further aid in identifying patients with early recurrence. Together, γ-GT, PIVKA-II, and AFP may a be used to develop a new prediction method to improve the prognosis of patients with HCC, and our results indicate the requirement of more active HCC treatment strategies.
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