肝胆胰外科杂志2024，Vol.36Issue(12)：709-715,7.DOI:10.11952/j.issn.1007-1954.2024.12.002
术前PIVKA-II水平对肝细胞癌患者行根治性切除术后生存和复发的预测价值
Preoperative PIVKA-Ⅱ levels for predicting the survival and recurrence for patients undergoing curative resection of hepatocellular carcinoma
摘要
Abstract
Objective To investigate the prognostic value of protein induced by vitamin K absence or antagonist-Ⅱ(PIVKA-Ⅱ)for long-term outcome in patients with hepatocellular carcinoma(HCC)after curative resection.Methods The clinical data of 792 patients who underwent curative hepatectomy for HCC at Eastern Hepatobiliary Surgery Hospital between Jan.2018 and Dec.2022 were retrospectively analyzed.Based on preoperative PIVKA-Ⅱ levels within 2 weeks before surgery,patients were stratified into normal PIVKA-Ⅱ group(<40 mAU/mL,n=179),high PIVKA-Ⅱ group(40-399 mAU/mL,n=245),and extremely high PIVKA-Ⅱ group(>399 mAU/mL,n=368).Clinical characteristics and postoperative outcomes were compared among the three groups.Overall survival(OS)and time to recurrence(TTR)were analyzed by using Kaplan-Meier method.Risk factors affecting postoperative prognosis were assessed by using Cox regression analysis.Results Compared with the normal PIVKA-Ⅱ group,both high and extremely high PIVKA-Ⅱ groups demonstrated significantly worse OS and TTR(P<0.001).Multivariate Cox regression analysis identified high PIVKA-Ⅱ level(HR 1.602,95％CI 1.807-2.362,P<0.001)and extremely high PIVKA-Ⅱ level(HR 2.457,95％CI 1.675-3.603,P<0.001)as independent risk factors for poorer OS.Extremely high PIVKA-Ⅱ level was also an independent risk factor for shorter TTR(HR 1.790,95％CI 1.350-2.304,P<0.001).Conclusion Preoperative PIVKA-Ⅱ levels can serve as an independent prognostic indicator for survival and recurrence of HCC after curative resection.Stratified assessment of PIVKA-Ⅱ levels aids in determining prognosis risk and guiding postoperative personalized follow-up and adjuvant therapy.关键词
维生素K缺乏或拮抗剂诱导的蛋白质Ⅱ/肝细胞癌/生存/复发/肝切除术Key words
protein induced by vitamin K absence or antagonist-Ⅱ/hepatocellular carcinoma/survival/recurrence/hepatectomy分类
医药卫生引用本文复制引用
尹东旭,杨田,刁永康,王明达,李超,姚岚清,顾丽慧,徐家豪,徐新飞,沈锋..术前PIVKA-II水平对肝细胞癌患者行根治性切除术后生存和复发的预测价值[J].肝胆胰外科杂志,2024,36(12):709-715,7.基金项目
国家自然科学基金项目(82273074). （82273074）
