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Lipoprotein (a): a promising prognostic biomarker in patients with hepatocellular carcinoma after curative resection

Authors Gao XH, Zhang SS, Chen H, Wang K, Xie W, Wang F

Received 1 February 2018

Accepted for publication 2 July 2018

Published 17 September 2018 Volume 2018:11 Pages 5917—5924

DOI https://doi.org/10.2147/OTT.S164273

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Lucy Goodman

Peer reviewer comments 3

Editor who approved publication: Professor Jianmin Xu


Xing-hui Gao,1,* Shuang-shuang Zhang,2,* Hao Chen,3 Kun Wang,4 Wen Xie,1 Fu-Bing Wang1

1Department of Laboratory Medicine, Zhongnan Hospital of Wuhan University, Wuhan 430071, People’s Republic of China; 2Department of Dermatology, Shanghai Skin Disease Hospital, Shanghai 200443, People’s Republic of China; 3Department of Pathology, Zhongnan Hospital of Wuhan University, Wuhan 430071, People’s Republic of China; 4Department of Laboratory Medicine, Hubei Cancer Hospital, Wuhan 430079, People’s Republic of China

*These authors contributed equally to this work

Purpose:
This study aimed to explore serum lipoprotein (a) (Lp(a)) levels and investigate their prognostic value in hepatocellular carcinoma (HCC) patients after curative resection.
Materials and methods: One cohort of 102 healthy individuals, one cohort of 172 HCC patients, and one cohort of 171 HCC patients undergoing curative resection were studied to evaluate serum Lp(a) levels and their prognostic significance, using Kaplan–Meier curves and log-rank tests.
Results: The Lp(a) levels in HCC patients were significantly lower than those in healthy individuals. Furthermore, the levels in HCC patients were significantly associated with recurrence. HCC patients were stratified into high Lp(a) (>20 mg/L) and low Lp(a) (≤20 mg/L) groups, using an optimal cutoff point for the Lp(a) of 20 mg/L. Low Lp(a) levels significantly correlated with tumor recurrence and survival time; HCC patients with low Lp(a) levels had higher recurrence rates and shorter survival time than those with high Lp(a) levels; Lp(a) was an independent prognostic factor for relapse-free survival and overall survival, and retained its prognostic value for α-fetoprotein ≤400 ng/mL and tumor size ≤5 cm subgroups in the training and validation cohorts.
Conclusion: Lp(a) was a promising and useful marker for assessing and monitoring recurrence and prognosis of patients with HCC, and improving Lp(a) levels may be a promising therapeutic strategy in HCC patients.

Keywords:
lipoprotein (a), hepatocellular carcinoma, recurrence, prognosis, survival, LP(a), HCC, recurrence, biomarker

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