Efficacy of P2/MS and AFP in Early Prediction of Hepatocellular Carcinoma Recurrence

Hepatoseluler Karsinoma Rekurrensinin Erken Tanisinda P2/MS ve AFP’nin Etkinligi Ozet Amac:  P2/MS basit, ucuz ve not-invaziv bir test olup sirozda karaciger fibrozunu degerlendirmek icin kullanilir. Hepatoseluler karsinomada artmis alfa-fetoprotein duzeyleri rekurrens ile iliskilidir. Bu calismada hepatoseluler karsinoma nuksunun erken donem ongorumunde P2/MS ve alfa-fetoproteinin etkinligi ve P2/MS ve alfa-fetoprotein icin sinir degerler belirlenmesi amaclanmistir. Gerec ve yontem:  Retrospektif olarak 69 hepatoseluler karsinoma hastasi, rekurrens varligi acisindan tarandi. Kanser rekurrensi radyolojik olarak trifazik tomografi ve manyetik rezonans inceleme ile belirlendi. P2/MS formulu icin [trombosit sayisi (10 9 /L)] 2 /[monosit yuzdesi x notrofil yuzdesi]  kullanildi. Bulgular:  Toplam 42 hastanin hepatoseluler karsinoma rekurrensi vardi. Rekurrens ongorumu icin P2/MS sinir degeri ≤59,9 alindiginda %100 ozgulluk ve %95,24 duyarlilik saptandi. Alfa-fetoprotein icin sinir degeri >57,5 alindiginda ise %83,3 ozgulluk ve %92,6 duyarlilik saptandi. Sonuc:  Bu bulgular isiginda, P2/MS ve alfa-fetoprotein hepatoseluler karsinoma rekurrensini ongordurmede guvenilir belirtecler olarak kabul edilebilir. Hepatoseluler karsinoma rekurrensinin erken tahmininde non-invaziv test olarak kullanilabileceklerini oneriyoruz.  Anahtar kelimeler:  P2/MS, AFP, hepatoseluler kanser, rekurrens. Efficacy of P2/MS and AFP in Early Prediction of Hepatocellular Carcinoma Recurrence Abstract:  Objective:  P2/MS is a simple, inexpensive and non-invasive test for the evaluation of hepatic fibrosis in cirrhosis. Elevated alpha-fetoprotein levels in hepatocellular carcinoma is related with recurrence. We aimed to examine the efficacy of P2/MS and alpha-fetoprotein in early prediction of hepatocellular carcinoma recurrence and to determine a cut-off value for P2/MS and alpha-fetoprotein.  Methods:  Sixty nine patients with hepatocellular carcinoma were  retrospectively scanned for recurrence existence. The recurrence of hepatocellular carcinoma was diagnosed radiologically, via 3-phase tomography and magnetic resonance investigation. The formula of P2/MS was platelet count (10 9 /L) 2 /[monocyte count (%) x neutrophil count (%)].  Results:  Forty two patients had hepatocellular carcinoma recurrence. For the recurrence prediction,  the  cut-off value of P2/MS was ≤59.9 with 100% specificity and 95.24% sensitivity. The cut-off value of alpha-fetoprotein was found >57.5 with 83.3% sensitivity and 92.6% specificity.  Conclusion:  With these findings, P2/MS and alpha-fetoprotein seems as  reliable markers for the prediction of hepatocellular carcinoma recurrence. We suggest that they can be used as non-invasive tools for the early estimation of hepatocellular carcinoma recurrence.  Key Words:  P2/MS, AFP, hepatocellular carcinoma, recurrence.