Role of blood AFP mRNA and tumor grade in the preoperative prognostic evaluation of patients with hepatocellular carcinoma

Table 1 Preoperative characteristics of the 50 enrolled HCC patients and univariate survival analysis

Variables	Study group (50 patients)	Likelihood-ratio χ2 (P value)
Median age (yr)	62 (22-88)	2.23 (NS)
Sex (M/F)	Sep-41	1.35 (NS)
Performance status (PST) ≥1	10	4.06 (.0438)
Cirrhosis	43	1.12 (NS)
Etiology: HCV/HBV/alcohol/other	29/6/5/10
Viral	3	1.7 (NS)
Portal hypertension	31	0.17 (NS)
Child-Pugh score (A/B/C)	16/24/3	2.31 (NS)
Analytical data
Bilirubin (μmol/L)	20 (7-233)	0.02 (NS)
Serum albumin (g/L)	35 (21-46)	0.49 (NS)
Prothrombin activity (%)	77 (39-109)	0.02 (NS)
1Alkaline phosphatase (U/L)	113 (42-395)	1.33 (NS)
1GGT (U/L)	64 (21-864)	3.25 (NS)
Creatinin (μmol/L)	83 (63-166)	1.47 (NS)
AST (U/L)	95 (20-492)	0.48 (NS)
ALT (U/L)	78 (12-469)	0.19 (NS)
Median AFP level (ng/L)	17 (4-1 400)	0.69 (NS)
Positive AFP mRNA	21	5.96 (0.0146)
TNM T3/T4	26	2.8 (NS)
Bilobar	7	2.38 (NS)
Number of nodules (1/2 or 3/>3)	22/23/5
Multinodular	28	0.99 (NS)
1Median nodule size (cm)	4 (1-18)	2.76 (NS)
Nodule >5 cm	20	1.62 (NS)
1Gross vascular invasion	12	4.42 (0.0354)
12Histological grade (I/II/III)	27/16/7
II-III	23	4.10 (0.0490)
Type of treatment
Resection/LT/loco-regional therapies	2022-7-21
Surgery	29	16.40 (0.0001)

HCV: hepatitis C virus; HBV: hepatitis B virus; AFP: alpha-fetoprotein; TNM: tumor node metastasis classification; LT: liver transplantation.

¹Variables significantly related to the presence of AFP mRNA in blood.

² I: well; II: moderately; and III: poorly differentiated HCC.

Table 2 Multivariate survival analysis in the 50 enrolled HCC patients. Only variables significantly influencing survival at univariate analysis were introduced in the Cox proportional hazard model

Variables	RR (95%CI)	Likelihood-ratio χ2	P
Assessing single variables
Surgery	2.72 (1.59-5.03)	14.07	0.0002
AFP mRNA	2.00 (0.90-4.82)	2.83	NS
Moderately or poorly differentiated grade	1.20 (0.55-2.41)	0.23	NS
Gross vascular invasion	0.86 (0.48-1.59)	0.24	NS
Performance status >1	1.21(0.64-2.46)	0.31	NS
Combining tumor related variables
Surgery	5.84 (2.23-17.32)	13.23	0.0003
1Early HCC	5.84 (2.23-17.32)	13.6	0.0002
Performance status >1	1.18 (0.41-3.09)	0.11	NS

RR: risk ratio; CI: confidence interval.

¹AFP mRNA negative and well-differentiated HCC without gross vascular invasion.