Clinical significance of preoperative CA19-9 combined with FIB levels in predicting early recurrence after liver resection for hepatocellular carcinoma

GAN Yu; WU Xiangbo; DAN Hanjun; DONG Xiaotian; GUAN Yufan; AN Jiaze

doi:10.13276/j.issn.2097-1656.2024.03.004

Abstract：Objective To investigate the clinical significance of carbohydrate antigen 19-9(CA19-9)combined with fibrinogen(FIB)in predicting early recurrence after liver resection for hepatocellular carcinoma.Methods A total of 164 patients with liver cancer admitted to Department of Hepatobiliary Surgery,Xijing Hospital,Air Force Medical University from June 2020 to June 2021 were selected for 2-year follow-up after surgical resection.According to the recurrence situation,the patients were divided into early recurrence(n =71)and non-early recurrence group(n =93).The baseline data of patients were collected,and the differences in preoperative CA19-9 and FIB levels between the two groups were compared.Multivariate logistic regression analysis was used to find the factors affecting the early recurrence after liver resection for hepatocellular carcinoma.Receiver operating characteristic(ROC)curve was used to evaluate the efficacy of preoperative CA19-9 and FIB in predicting early recurrence after liver resection for hepatocellular carcinoma.Results Among 164 patients,71(43.3%)had early recurrence after hepatectomy.Multivariate logistic regression analysis showed that advanced Barcelona Clinic Liver Cancer(BCLC)stage,tumor undifferentiation,intraoperative blood transfusion,preoperative AFP>400 g/L,CA19-9>17.95 U/mL,and FIB>2.73 g/mL(all P<0.05)were independent risk factors for early recurrence after liver resection for hepatocellular carcinoma.ROC curve analysis showed that the area under ROC curve(AUC),sensitivity,and specificity of CA19-9 in predicting early recurrence after liver resection for hepatocellular carcinoma were 0.793(95%CI:0.723-0.862),0.662,and 0.817,respectively.The AUC,sensitivity,and specificity of FIB in predicting early recurrence after liver resection for hepatocellular carcinoma were 0.800(95%CI:0.734 0.866),0.648,and 0.753,respectively.The AUC,sensitivity,and specificity of combined CA19-9 and FIB levels in predicting early recurrence after liver resection for hepatocellular carcinoma were 0.913(95%CI:0.869-0.958),0.831,and 0.925,respectively.Conclusion Advanced BCLC stage,tumor undifferentiation,intraoperative blood transfusion,preoperative AFP>400 g/L,CA19-9>17.95 U/mL,and FIB>2.73 g/mL are closely related to early recurrence after liver resection for hepatocellular carcinoma.The combination of CA19-9 and FIB levels has a higher value in predicting early recurrence after liver resection for hepatocellular carcinoma.