Serum tissue polypeptide specific antigen as a noninvasive prognostic indicator for early recurrence of hepatocellular carcinoma after curative resection

Abstract

BACKGROUND Serum tissue polypeptide specific antigen (TPS) is a useful cell proliferation marker in diagnosing and monitoring patients with a variety of malignancies. The objective of this study was to determine the usefulness of serum TPS as a noninvasive prognostic factor for early recurrence of hepatocellular carcinoma (HCC) after patients undergo curative resection. METHODS Serum TPS levels were measured by monoclonal TPS immunoradiometric assay in 54 patients shortly before they underwent curative resection for HCC. The recurrence time was correlated with the TPS level and with other prognostic factors using the log‐rank test in univariate analysis and a Cox regression in multivariate analysis. Receiver operating characteristic analysis was performed to examine the power of the various prognostic factors to distinguish between patients with recurrent tumors and patients who were disease free. RESULTS Patients who had higher levels of TPS (≥ 150 U/L) had earlier recurrences compared with patients who had lower levels of TPS (< 150 U/L; P = 0.016) in univariate analysis. Tumor size, the number of tumors, portal vein invasion, and the resection margins also were associated significantly with the time to tumor recurrence (P = 0.015, P = 0.004, P = 0.003, and P = 0.003, respectively). Serum α‐fetoprotein was not a significant risk factor for tumor recurrence. In multivariate analysis, the TPS level, tumor size, and resection margins were independent prognostic factors (P = 0.025, P = 0.018, and P = 0.016, respectively). The inclusion of TPS in addition to tumor size and resection margins increased the rate of corrective prediction from 0.72 to 0.80. CONCLUSIONS The current study demonstrated that the preoperative serum TPS level was a significant factor in predicting early recurrence of HCC after curative resection. Patients with high serum TPS levels warrant more aggressive treatment and close follow‐up after they undergo tumor resection. Cancer 2002;95:112–8. © 2002 American Cancer Society. DOI 10.1002/cncr.10626

Keratins: Biomarkers and modulators of apoptotic and necrotic cell death in the liver

“…For example, patients with alcoholic hepatitis displayed increased CYFRA 21‐1 levels, which meshes well with the associated strong ductular reaction . Unlike CYFRA 21‐1, TPA and TPS are commonly elevated in patients with both malignant and nonmalignant liver diseases and therefore lack sufficient specificity for HCC detection . On the other hand, increased TPS levels may predict early HCC recurrence after curative resection .…”

“…Unlike CYFRA 21‐1, TPA and TPS are commonly elevated in patients with both malignant and nonmalignant liver diseases and therefore lack sufficient specificity for HCC detection . On the other hand, increased TPS levels may predict early HCC recurrence after curative resection . In cirrhosis, TPA strongly correlates with (but might be more sensitive than) AST values .…”

Multimodal Treatment of Hepatocellular Carcinoma (HCC)

“…A competitive RT-PCR assay for AFP-mRNA showed positive results in 26% of HCC patients, in 17% of patients with tumors of different typesand in 8% of healthy controls [19]. The cell proliferation marker tissue polypeptide specific antigen (TPS) may be more predicative: with preoperatively elevated TPS serum levels >150 U/l the probability of recurrence after curative resection was higher (2-year recurrence rate 53.3 vs. 20.8%), whereas no correlation was observed for AFP [20]. An HCC detection rate of 92% was reported for ultrafast contrast enhanced CT.…”