Alpha-Fetoprotein+Alkaline Phosphatase (A-A) Score Can Predict the Prognosis of Patients with Ruptured Hepatocellular Carcinoma Underwent Hepatectomy.

Abstract

Background:

This research is aimed at establishing a scoring system alpha-fetoprotein+alkaline phosphatase (A-A score) based on preoperative serum alpha-fetoprotein (AFP) and alkaline phosphatase (ALP) levels and to investigate its clinical significance in patients with ruptured hepatocellular carcinoma (rHCC) after hepatectomy.

Methods:

175 ruptured hepatocellular carcinoma (HCC) patients treated with hepatectomy were included. Survival analysis was assessed by the Kaplan-Meier method. Prognostic factors were analyzed in a multivariate model. Preoperative serum AFP and ALP values are assigned a score of 1 if they exceed the threshold value and 0 if they are below the threshold value, A-A score is obtained by summing the scores of two variables (AFP, ALP), and the predictive values of AFP, ALP, and A-A score were compared by receiver operating characteristic curve (ROC) analysis, and subgroup analyses were performed to further evaluate the power of A-A scores.

Results:

Of the 175 patients, 67 (38.3%) had an A-A score of 0, 72 (41.1%) had an A-A score of 1, and 36 (20.6%) had an A-A score of 2. In multivariate analysis, the A-A score, the BCLC stage, and the extent of resection were independent predictors of OS in patients with rHCC. The 1-, 3-, and 5-year OS and RFS in patients with an A-A score of 1 were better than those with an A-A score of 0 and worse than those with an A-A score of 1 (all p < 0.05). Based on the results of ROC analysis, the A-A score is superior to AFP or ALP alone in predicting the prognosis of patients with ruptured HCC. In subgroup analysis, A-A score could accurately predict the prognosis of patients with or without microvascular invasion (MVI) and with different Child-Pugh grades or gender.

Conclusions:

The A-A score can effectively predict the prognosis of patients after hepatectomy of ruptured hepatocellular carcinoma. At the same time, it also has good evaluation ability in different subgroups.

• Authors: Feng Xia, Elijah Ndhlovu, Zhicheng Liu, Xiaoping Chen, Bixiang Zhang, Peng Zhu
• Journal: Disease markers (Dis Markers) Vol. 2022 Pg. 9934189 ( 2022) ISSN: 1875-8630 [Electronic] United States
• PMID: 35493302 (Publication Type: Journal Article)
• Copyright: Copyright © 2022 Feng Xia et al.

Chemical References

• alpha-Fetoproteins
• Alkaline Phosphatase

Topics

• Alkaline Phosphatase
• Carcinoma, Hepatocellular (pathology)
• Hepatectomy
• Humans
• Liver Neoplasms (pathology)
• Prognosis
• alpha-Fetoproteins