Villa et al used the estrogen receptor (ER) status in hepatocellular carcinoma to classify patients into low and high risk groups. The authors are from the University of Modena and Reggio Modena and the University of Palermo in Italy.
ER types based on RT-PCR:
(1) wild type
(2) variant
where:
• The ER type was based on either (a) being the sole type present, or (b) have a band density >= 2 times that of the other band.
|
ER Type |
Median Survival |
95% CI |
|
wild type |
36 months |
12.9 to 59.1 |
|
variant |
13 months |
8.3 to 17.7 |
Additional risk factors:
(1) serum bilirubin
(2) alpha-fetoprotein
(3) portal vein thrombosis
|
Parameter |
Finding |
Points |
|
serum bilirubin |
< 50 µmol/L |
0 |
|
|
>= 50 µmol/L |
1 |
|
alpha-fetoprotein |
< 400 ng/dL (< 4 ng/mL) |
0 |
|
|
>= 400 ng/dL (>= 4 ng/mL) |
1 |
|
portal vein thrombosis |
absent |
0 |
|
|
present |
1 |
where:
• The normal range according to Tietz (Clinical Guide to Laboratory Tests) in adults is < 8.5 ng/mL.
• In CLIP (above, also from Italian investigators) uses the same decision point for AFP. The normal reference range for AFP was given as < 10 ng/dL. As for the CLIP, I will use a multiple of the upper range of normal (40 times) for the implementation.
|
Parameter |
Relative Risk |
95% CI |
p value |
|
ER type |
4.1 |
2.4 to 6.9 |
0.000 |
|
serum bilirubin |
2.9 |
1.6 to 5.2 |
0.001 |
|
AFP |
3.2 |
1.6 to 6.3 |
0.001 |
|
portal vein thrombosis |
3.3 |
1.3 to 8.2 |
0.012 |
from Table 6, page 444
Specialty: Hematology Oncology, Surgery, general, Gastroenterology
ICD-10: ,
