Patients with hepatocellular carcinoma with triple-positive tumor markers may benefit from postsurgery adjuvant...

This study aimed to explore the correlation between the number of positive tumor markers and clinical-pathologic-ultrasonic-prognostic characteristics of hepatocellular carcinoma (HCC) and to determine the importance of postoperative adjuvant therapy in patients with HCC with different numbers of positive tumor markers.

This retrospective study analyzed 649 patients with HCC. The relationships between clinical-pathologic-ultrasonic-prognostic characteristics and 3 tumor markers, alpha-fetoprotein (AFP), des-gamma-carboxy prothrombin, and Lens culinaris agglutinin-reactive fraction of AFP, were analyzed. Cumulative recurrence-free survival (RFS) was analyzed according to the number of positive tumor markers and according to the presence or absence of postoperative adjuvant therapy in each group.

The expression patterns of 3 tumor markers were associated with transaminase, maximum diameter, microvascular invasion, macrovascular invasion, satellite nodule, echogenicity consistency, morphology, color Doppler flow imaging pattern, and wash-out degree. Traditional Chinese medicine was the predominant intervention (32.00%) in the triple-negative group, and transarterial chemoembolization monotherapy was the most common intervention in the single-positive group (42.99%), double-positive group (39.51%), and triple-positive group (35.48%). Cox proportional hazards regression analyses revealed that positive tumor markers were associated with poor RFS. There was a significant difference between patients who received postoperative adjuvant therapy and those who did not receive postoperative adjuvant therapy in the triple-positive group (30.0 vs 19.6 months, respectively; P =.019).

The number of positive tumor markers showed different clinical-pathologic-ultrasonic-prognostic characteristics. Preoperative serum tumor markers provided a more convenient and noninvasive method to determine patients with a high risk of recurrence, resulting in more appropriate surgical strategies and postoperative adjuvant therapies.