Journal of Clinical and Translational Hepatology

Journal of Clinical and Translational Hepatology

Friday, 08 / 18 / 2017

Articles

The Number of Positive Tumor Marker Status Is Beneficial for the Selection of Therapeutic Modalities in Patients with Hepatocellular Carcinoma

REVIEW ARTICLE

The Number of Positive Tumor Marker Status Is Beneficial for the Selection of Therapeutic Modalities in Patients with Hepatocellular Carcinoma

Toru Beppu*1,2, Shigeki Nakagawa2, Hidetoshi Nitta2, Hirohisa Okabe2, Takayoshi Kaida2, Katsunori Imai2, Hiromitsu Hayashi2, Yuki Koga1,2, Kunitaka Kuramoto1,2, Daisuke Hashimoto2, Yo-ichi Yamashita2, Akira Chikamoto2, Takatoshi Ishiko2 and Hideo Baba2

1Department of Surgery, Yamaga City Medical Center, Kumamoto, Japan
2Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan

*Correspondence to: Toru Beppu, Department of Surgery, Yamaga City Medical Center, 511, Yamaga, Kumamoto 861-0593, Japan. Tel: +81-968-44-2185, Fax: +81-968-44-2420, E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

Journal of Clinical and Translational Hepatology 2017;5(2):165-168 DOI: 10.14218/JCTH.2016.00055
Received: October 26, 2016 Accepted: April 13, 2017 Published online: May 10, 2017

Abstract

Hepatic resection (HR) and radiofrequency ablation (RFA) are popular local therapies for early-stage hepatocellular carcinoma (HCC). Alpha-fetoprotein, Lens culinaris agglutinin-reactive fraction of alpha-fetoprotein, and des-c-carboxy prothrombin are well-known and useful tumor markers for HCC. The positive number status of these tumor markers has recently been demonstrated as beneficial for predicting outcome for HCC patients treated with local therapy. Although the normal ranges reported have differed by institution, the positivity of tumor markers is consistent and can easily be assessed. Kumamoto and Wakayama’s group clearly demonstrated the following: 1) Regardless of the degree of tumor stage, a triple-positive tumor marker profile can predict poor outcome in HCC patients undergoing HR; 2) For RFA alone, HCC patients with double- and triple-positive status, having less than three lesions and lesions ≤3 cm in diameter show comparably insufficient outcomes; 3) For HCC patients with lesions ≤5 cm in Child–Pugh grade A, HR is preferred over RFA; 4) Microvascular invasion rates increased even in the double-positive patients, while poorly differentiated HCC was frequently observed only in the triple-positive patients; and 5) RFA with chemoembolization, anatomical liver resection, and postoperative adjuvant chemoembolization or hepatic arterial chemotherapy might improve the outcome for patients with highly malignant HCC with multiple positive tumor markers. However, the impacts of these therapies still need to be evaluated in prospective comparative studies.

Keywords

Triple-positive tumor markers, Double-positive tumor markers, Hepatocellular carcinoma, Hepatic resection, Radiofrequency ablation, Alpha-fetoprotein, Des-γ-carboxy prothrombin, Lens culinaris agglutinin reactive fraction of alpha-fetoprotein

 

 

Journal of Clinical and Translational Hepatology 2017 vol. 5 Html ] [ PDF Full-text ]

© The Authors 2017. This article is published under the terms of the Creative Commons Attribution-Noncommercial (CC BY-NC) License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license.

 

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