Value of α-fetoprotein in predicting the curative effect of microwave ablation for hepatocellular carcinoma

Abstract

Objective To investigate the value of α-fetoprotein (AFP) in predicting the curative effects of microwave ablation for hepatocellular carcinoma (HCC).Methods The clinical data of 213 HCC patients who received microwave ablation at the Chinese PLA General Hospital from January 2005 to July 2010 were retrospectively analyzed.The AFP level was detected one week before treatment,and all the patients were divided into the AFP-negative ( AFP ＜ 20 μg/L) group (99 patients) and AFP-positive ( AFP ≥20 μg/L) group ( 114 patients).All patients were closely followed up until October 2010,and the clinicopathological data,survival estimates,complications and prognosis-relative factors were recorded.All data were analyzed by the t test,rank sum test,analysis of variance or Logistic regression analysis.The survival curve was drawn by the Kaplan-Meier method,and the survival was analyzed by the Log-rank test.Results The 5-year local tumor progression rate,intrahepatic and extrahepatic metastasis were 5.5％,44.6％ and 9.9％,respectively.The 1-,2-,3-,4-,5-year accumulative survival rates were 95.6％,86.1％,77.3％,72.7％ and 67.5％,respectively.Eleven patients died in the AFP-negative group,and the 1-,3-,5-year accumulative survival rates were 97.8％,85.4％ and 74.6％,respectively.Twenty-three patients died in the AFP-positive group,and the 1-,3-,5-year accumulative survival rates were 93.9％,71.6％ and 61.3％,respectively.There was no significant difference in the survival between the 2 groups ( x2 =1.68,P ＞ 0.05 ).The results of univariate analysis showed that the preablation AFP level was associated with the complication rate,postablation intrahepatic metastasis and the survival ( Z =- 1.98,-3.46,- 1.92,P ＜ 0.05 ).The results of multivariate analysis showed that the preablation AFP level was associated with the gender,tumor diameter,hepatic cirrhosis and major complications (t =2.60,3.78,1.97,2.06,P ＜ 0.05 ).Conclusion Higher level of preablation AFP associates with poor prognosis after microwave ablation. Key words: Liver neoplasms; α-fetoprotein; Microwave ablation; Prediction