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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 6/2018

01-06-2018 | Hepatobiliary Tumors

Application of Serum Annexin A3 in Diagnosis, Outcome Prediction and Therapeutic Response Evaluation for Patients with Hepatocellular Carcinoma

Authors: Xiao-Lu Ma, MM, Mi Jiang, BSM, Ying Zhao, BSM, Bei-Li Wang, PhD, Min-Na Shen, BSM, Yan Zhou, MM, Chun-Yan Zhang, MM, Yun-Fan Sun, PhD, Jian-Wen Chen, PhD, Bo Hu, PhD, Zi-Jun Gong, PhD, Xin Zhang, PhD, Ya Cao, PhD, Bai-Shen Pan, MD, Jian Zhou, PhD, MD, Jia Fan, PhD, MD, Xin-Rong Yang, PhD, MD, Wei Guo, PhD

Published in: Annals of Surgical Oncology | Issue 6/2018

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Abstract

Purpose

Annexin A3 (ANXA3) could induce progression of hepatocellular carcinoma (HCC) via promoting stem cell traits of CD133-positive cells. Moreover, serum ANXA3 showed preliminary diagnostic potential, however further validation was required. Meanwhile, the prognostic value of ANXA3 remained elusive. The present study aimed to validate diagnostic performance and further systematically investigate the prognostic value of serum ANXA3.

Methods

Serum ANXA3 of 368 HCC patients was determined by enzyme-linked immunosorbent assay (ELISA); 295 of these patients underwent resection and 73 underwent transcatheter arterial chemoembolization (TACE). Diagnostic performance of ANXA3 was evaluated by receiver operating characteristic (ROC) analysis, and the prognostic value was evaluated by Cox regression and Kaplan–Meier analysis. To evaluate the relationship between serum ANXA3 and circulating CD133 mRNA-positive tumor cells (CD133mRNA+ CTCs), real-time polymerase chain reaction was conducted in 69 patients who underwent resection.

Results

Serum ANXA3 provided greater diagnostic performance than α-fetoprotein (area under the curve [AUC] 0.869 vs. 0.782), especially in early diagnosis (AUC 0.852 vs. 0.757) and discriminating HCC from patients at risk (0.832 vs. 0.736). Pretreatment ANXA3 was an independent predictor of tumor recurrence (hazard ratio [HR] 1.87, 95% confidence interval [CI] 1.26–2.76, p = 0.002)/progression (HR 1.88, 95% CI 1.04–3.43, p = 0.038) and survival (resectable: HR 2.26, 95% CI 1.44–3.56, p = 0.001; unresectable: HR 2.08, 95% CI 1.10–4.05, p = 0.025), and retained its performance in low-recurrence-risk subgroups. Specifically, dynamic changes of ANXA3-positive status was associated with worse prognosis. ANXA3 was positively correlated with CD133mRNA+ CTCs (r = 0.601, p < 0.001). In patients with detectable CD133mRNA+ CTC, high ANXA3 was positively associated with a higher risk of recurrence and shorter overall survival.

Conclusions

Serum ANXA3 shows promise as a biomarker for diagnosis, outcome prediction, and therapeutic response evaluation in patients with HCC.
Appendix
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Metadata
Title
Application of Serum Annexin A3 in Diagnosis, Outcome Prediction and Therapeutic Response Evaluation for Patients with Hepatocellular Carcinoma
Authors
Xiao-Lu Ma, MM
Mi Jiang, BSM
Ying Zhao, BSM
Bei-Li Wang, PhD
Min-Na Shen, BSM
Yan Zhou, MM
Chun-Yan Zhang, MM
Yun-Fan Sun, PhD
Jian-Wen Chen, PhD
Bo Hu, PhD
Zi-Jun Gong, PhD
Xin Zhang, PhD
Ya Cao, PhD
Bai-Shen Pan, MD
Jian Zhou, PhD, MD
Jia Fan, PhD, MD
Xin-Rong Yang, PhD, MD
Wei Guo, PhD
Publication date
01-06-2018
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 6/2018
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-018-6402-0

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