The des-gamma-carboxy prothrombin index is a new prognostic indicator for hepatocellular carcinoma.

Abstract

BACKGROUND:

Des-gamma-carboxy prothrombin (DCP) has been reported to be an important prognostic factor in patients with hepatocellular carcinoma (HCC). Recently, a monoclonal antibody, 19B7, which recognizes the Gla domain of DCP, has been identified. The 19B7 antibody recognizes an epitope different from that recognized by MU-3, which is another antibody against DCP. In this study, the authors investigated the measurement of DCP using the antibodies MU-3 and 19B7, respectively, as a prognostic factor for patients with HCC who had solitary, small tumors and or Child Stage A HCC.

METHODS:

One hundred four patients with HCC who had solitary, small tumors or Child Stage A tumors were enrolled in the study between 1991 and 2001. All patients were treated and were followed for a mean of 3.2 years. The authors analyzed the correlation between the DCP Index (DCP measured by MU-3 and DCP measured by 19B7) and patient prognosis. The patients were classified into 3 groups based on their DCP Index: 1) DCP negative (DCP < 40 milli arbitrary unit (mAU)/mL)); 2) low DCP Index (DCP > or = 40 mAU/mL; MU-3:19B7 ratio, < 3.0; and 3) high DCP Index (DCP > or = 40 mAU/mL; MU-3:19B7 ratio, > or = 3.0).

RESULTS:

The survival rate for patients in the high DCP Index group was lower compared with the survival rate for patients in the DCP-negative group and was significantly lower compared with the survival rate for patients in the low DCP Index group. In a univariate Cox proportional hazards model, the positive factors were high DCP Index and low DCP Index. Among the positive predictive factors that were analyzed using a multivariate Cox proportional hazards model were age (hazard ratio, 3.27; P = 0.006), low DCP Index (hazard ratio, 2.87; P = 0.012), and high DCP Index (hazard ratio, 12.3; P < 0.0001).

CONCLUSIONS:

The prognosis of patients who had a high DCP Index score was poorer compared with patients who had a low DCP Index score and patients who were classified as DCP negative. The authors concluded that the DCP Index is a prognostic indicator for patients with HCC.

• Authors: Sakae Nagaoka, Hiroshi Yatsuhashi, Hisayuki Hamada, Koji Yano, Takehiro Matsumoto, Manabu Daikoku, Kokichi Arisawa, Hiromi Ishibashi, Michiaki Koga, Michio Sata, Michitami Yano
• Journal: Cancer (Cancer) Vol. 98 Issue 12 Pg. 2671-7 (Dec 15 2003) ISSN: 0008-543X [Print] United States
• PMID: 14669288 (Publication Type: Comparative Study, Journal Article)
• Copyright: Copyright 2003 American Cancer Society.

Chemical References

• Antibodies, Monoclonal
• Biomarkers
• Biomarkers, Tumor
• Protein Precursors
• Reagent Kits, Diagnostic
• acarboxyprothrombin
• Prothrombin

Topics

• Aged
• Antibodies, Monoclonal (blood)
• Biomarkers
• Biomarkers, Tumor (blood)
• Carcinoma, Hepatocellular (blood, diagnosis, therapy)
• Female
• Humans
• Liver Neoplasms (blood, diagnosis, therapy)
• Male
• Middle Aged
• Prognosis
• Protein Precursors (blood, immunology)
• Prothrombin (immunology)
• Reagent Kits, Diagnostic
• Survival Rate