Carbohydrate Antigen 19-9 Increases the Predictive Efficiency of a-Fetoprotein for Prognosis of Resected Hepatocellular Carcinoma

Abstract

Serum α-fetoprotein (AFP) is a classical biomarker for both diagnosis and prognosis of hepatocellular carcinoma (HCC). However, its predictive efficiency for prognosis remains unsatisfactory. This study explores whether integrating AFP and carbohydrate antigen (CA) 19-9/carcinoembryonic antigen (CEA) increase its prognostic efficiency in HCC. A total of 67 HCC patients with complete record of AFP, CA19-9, and CEA, who underwent radical hepatectomy, were included. The sole and combined evaluations for prognostic significance of the three markers were performed. In the first, it was found by one-factor analysis that AFP was a univariate prognostic indicator for disease-free survival, but not overall survival, whereas CEA and CA19-9 were not statistically significant, although the latter was of marginally predictive significance for disease-free survival. Subsequently, it was revealed that combined evaluation of AFP and CA19-9, rather than AFP and CEA, distinguished overall and disease-free survival more effectively, compared with single ones. However, this combination was not significant in multivariate Cox regression analysis, thus needing further validation, especially in large-scale prospective investigations. The addition of vascular invasion to AFP/CA19-9 combination might provide enhanced predictive power for disease-free survival. Collectively, these results preliminarily suggest that CA19-9 increases the predictive efficiency of AFP for prognosis of HCC after resection.

Prognostic significance of combined α-fetoprotein and CA19-9 for hepatocellular carcinoma after hepatectomy

“…In another study on the relationship between preoperative serum AFP level and prognosis of HCC patients, 20 ng/mL and 400 ng/mL were selected as cut-off values, and the results showed that preoperative serum AFP level has considerable predictive value for the malignant feature and a preoperative AFP value >400 ng/mL was independent prognostic factors for long-term survival and associated with poor prognosis after resection for HCC [ 13 ]. The efficiency of their combination as a prognostic factor for HCC patients after hepatectomy has not yet been reported, except for a retrospective study of only 67 patients [ 14 ]. Therefore, here, we aimed to retrospectively compare the prognostic value of CA19-9 and AFP levels, individually and together, in HCC patients after hepatectomy.…”

<em>NT5DC2</em> is a novel prognostic marker in human hepatocellular carcinoma

“…Previous studies have been conducted to identify potential biomarkers. It has been revealed that frequently used biomarkers, such as α-fetoprotein (AFP) ( 8 ) and carbohydrate antigen 19-9 (CA19-9) ( 9 ), have a relatively poor performance as predictors of long-term outcome.…”

Prognostic Value of Lactate Dehydrogenase in Patients with Hepatocellular Carcinoma: A Meta-Analysis

“…Radical resection is currently the best treatment for HCC, but tumor recurrence and distant metastasis after surgery are the biggest problems affecting patient prognosis [2]. At present, the traditional tumor biomarker alpha-fetoprotein (AFP) is used to predict the prognosis of patients with hepatocellular carcinoma, but its sensitivity and specificity are not satisfactory [3, 4]. Therefore, it is crucial to find a valuable novel biomarker for predicting the prognosis of hepatocellular carcinoma.…”