Objective: To investigate the early-recurrence prediction value of preoperative alpha-1-fucosidase (AFU) for hepatocellular carcinoma (HCC) patients undergoing curative resection.
Methods: A retrospective training set data from January to July, 2012 including 116 patients and a prospective validation set from August 2012 to December 2012 including 68 patients were used to validate the predictive value of preoperative AFU. Difference of recurrence rates between low and high AFU populations in all HCC or early-HCC subgroups were compared via Kaplan-Meier curves and Log-rank tests. Univariate and multivariate analyses were used to identify the recurrent prediction value of preoperative serum AFU.
Results: Based on retrospective training data, AFU = 25.00 U/L was set as the optimal cutoff point to stratify HCC patients into high (>25.00 U/L) and low ( ≤ 25.00 U/L) groups. Patients with high preoperative AFU showed significant low tumor-free survival not only in whole patients group (mean 12.50 months vs.not reached; P < 0.01) but also in early-HCC (mean 10.25 months vs.not reached, P < 0.01) and AFP negative subgroups (mean 13.20 months vs not reached, P < 0.01). Univariate and multivariate analyses revealed the AFU was an independent predictor for tumor recurrence (OR = 1.72, 95%CI:1.00-2.96, P = 0.04). The prospective validation data confirmed the predictive value of preoperative AFU in HCC (OR = 2.22, 95%CI:0.67-7.37, P = 0.04). Furthermore, patients with high preoperative AFU were prone to have bigger tumor and form vascular invasion.
Conclusion: Preoperative AFU is a powerful prognostic indicator for HCC and 25.00 U/L might be an optimal recurrence prediction cutoff value for patients in Zhongshan hospital.