Digestive Diseases and Sciences

, Volume 61, Issue 3, pp 937–947 | Cite as

Low Alpha-Fetoprotein Levels Are Associated with Improved Survival in Hepatocellular Carcinoma Patients with Portal Vein Thrombosis

Original Article

Abstract

Background

Macroscopic portal vein thrombosis (PVT) is a common and dire prognostic feature of patients with hepatocellular carcinoma (HCC) and often precludes many treatments as a result. Little is known about its causes or mechanisms or clinical associations.

Aims

To examine patients with PVT in order to possibly identify prognostically different subsets.

Methods

A large cohort of non-curable patients with advanced and biopsy-proven HCC in which survival was documented, were retrospectively examined.

Results

We analyzed a large HCC cohort containing 366 (63.3 %) PVT-positive patients and found that PVT is associated with patients having larger tumors and higher levels of alpha-fetoprotein (AFP) and des-gamma carboxyprothrombin (DCP). We identified in patients with normal bilirubin levels (≤2.0 mg/dl) two PVT-positive patients, having higher and lower AFP levels, respectively. They differed in the significantly better prognosis of the low AFP patients, which may be useful for patient management decisions.

Conclusions

Patients with PVT are heterogeneous with respect to AFP levels. AFP-negative patients have a significantly better survival than those who have elevated AFP.

Keywords

Portal vein thrombosis AFP DCP Survival 

Abbreviations

HCC

Hepatocellular carcinoma

PVT

Portal vein thrombosis

AFP

Alpha-fetoprotein

DCP

Des-gamma carboxyprothrombin

GGT

Gamma glutamyl transpeptidase

ALKP

Alkaline phosphatase

AST

Aspartate aminotransferase

Hb

Hemoglobin

MTD

Maximum tumor diameter

CT

Computerized axial tomography

MRI

Magnetic resonance imaging

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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  1. 1.Izmir Biomedicine and Genome CenterDokuz Eylul UniversityIzmirTurkey
  2. 2.IRCCS de BellisNational Institute for Digestive DiseasesCastellana GrotteItaly

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