Sezgin VATANSEVER, Fatih Esat TOPAL, Suleyman GÜNAY, Firdevs TOPAL, Ünal TAŞDEMİR, Zeynep Zehra GÜMÜŞ, Sabiye AKBULUT, Elif SARITAŞ YÜKSEK

P2/MS ve AFP'nin Hepatoselüler Kanser Nüksünü Öngördürmedeki Yeri

Amaç: P2/MS sirozdaki karaciğer fibrozunu değerlendirmek kullanılan basit, pahalı olmayan, non-invaziv bir testtir. Hepatoselüler karsinomda artmış alfa-fetoprotein düzeyleri ise rekürrens ile ilişkilidir. Bu çalışmada hepatoselüler karsinom nüksünün erken öngörümünde P2/MS ve alfa-fetoprotein etkinliğini değerlendirmeyi ve bir cutoff değeri araştırmayı amaçladık. Gereç ve Yöntem: Hepatoselüler karsinoması olan 69 hasta retrospektif olarak rekürrens varlığı açısından tarandı. Hastalardaki rekürrens varlığı radyolojik olarak trifazik bilgisayarlı tomografi ve magnetik rezonans inceleme ile değerlendirildi. P2/MS formülü olarak trombosit sayısı (109 /L)2 /[monosit yüzdesi (%) x nötrofil yüzdesi (%)]. Bulgular: Toplam 42 hastada hepatoselüler karsinom rekürrensi belirlendi. Rekürrens öngörümü açısından P2/MS cut-off değeri ≤59.9 alındığında %100 spesifite ve %95.24 sensiviteye sahip olduğu bulundu. Alfa-fetoprotein için cut-off değeri >57.5 alındığındaysa sensivitesi %83.3 ve spesifitesi %92.6 saptandı. Sonuç: Bu bulgular ışığında P2/MS ve alfa-fetoproteinin hepatoselüler karsinom rekürrensini öngördürmede güvenilir belirteçler gibi değerlendirilebilmektedir. Bu iki non-invaziv yöntemin hepatoselüler rekürrensinin erken tahmininde kullanılması gerektiğini önermekteyiz

Efficacy of P2/MS and AFP in Early Prediction of Hepatocellular Carcinoma Recurrence

Objective: P2/MS is a simple, inexpensive and non-invasive test for the evaluation ofhepatic fibrosis in cirrhosis. Elevated alpha-fetoprotein levels in hepatocellularcarcinoma is related with recurrence. We aimed to examine the efficacy of P2/MS andalpha-fetoproteinin early prediction of hepatocellular carcinoma recurrence and todetermine a cut-off value for P2/MS and alpha-fetoprotein.Methods: Sixty nine patients with hepatocellular carcinoma were retrospectivelyscanned for recurrence existence. The recurrence of hepatocellular carcinoma wasdiagnosed radiologically, via 3-phase tomography and magnetic resonanceinvestigation. The formula of P2/MS was platelet count (109/L)2/[monocyte count(%)x neutrophil count(%)].Results: Forty two patients had hepatocellular carcinoma recurrence. For therecurrence prediction, the cut-off value of P2/MS was ≤59.9 with 100% specificityand 95.24% sensitivity. The cut-off value of alpha-fetoprotein was found >57.5 with83.3% sensitivity and 92.6% specificity.Conclusions: With these findings, P2/MS and alpha-fetoprotein seems as reliablemarkers for the prediction of hepatocellular carcinoma recurrence. We suggest thatthey can be used as non-invasive tools for the early estimation of hepatocellularcarcinoma recurrence

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ISSN: 1309-3878
Yayın Aralığı: Yılda 3 Sayı
Başlangıç: 2009
Yayıncı: Düzce Üniversitesi Tıp Fakültesi Aile Hekimliği AD adına Yrd.Doç.Dr.Cemil Işık Sönmez