Selection tool alpha-fetoprotein for patients waiting for liver transplantation: How to easily manage a fractal algorithm  

作　　者：Quirino Lai Giovanni Battista Levi Sandri Jan Lerut 

机构地区：[1]Transplant Unit,Department of Surgery, University Aquila, San Salvatore Hospital [2]Starzl Unit Abdominal Transplantation, University Hospitals Saint Luc, Université catholique Louvain [3]Department of General Surgery and Organ Transplantation, Umberto I Hospital, Sapienza University

出　　处：《World Journal of Hepatology》2015年第15期1899-1904,共6页世界肝病学杂志（英文版）（电子版）

摘　　要：Alpha-fetoprotein(AFP) behavior in patients with hepatocellular carcinoma(HCC) waiting for liver transplant(LT) represents a perfect biological example of a fractal model in which its progressive modification and possible future prediction of its values are very hard to capture. As a consequence, AFP represents a useful but poorly manageable tool to increase the ability to better select HCC patients waiting for LT. Trying to find a "filrouge" in the recent literature, no definitive answers can be done to several open questions:(1) the best AFP value to adopt;(2) the best cut-off measurement; and(3) the best way to comfortably capture the effective, time-related, fluctuations of this biological marker. More, structured and prospective, studies using serial determination of AFP values within and without the context of locoregional therapies are needed in order to find the "ideal"(static and dynamic) cut-off values allowing to respond to all the still open questions in this field of transplant oncology.Alpha-fetoprotein （AFP） behavior in patients withhepatocellular carcinoma （HCC） waiting for liver transplant（LT） represents a perfect biological example of afractal model in which its progressive modification andpossible future prediction of its values are very hard tocapture. As a consequence, AFP represents a useful butpoorly manageable tool to increase the ability to betterselect HCC patients waiting for LT. Trying to find a ＂filrouge＂in the recent literature, no definitive answers canbe done to several open questions （1） the best AFPvalue to adopt; （2） the best cut-off measurement; and（3） the best way to comfortably capture the effective,time-related, fluctuations of this biological marker.More, structured and prospective, studies using serialdetermination of AFP values within and without thecontext of locoregional therapies are needed in orderto find the ＂ideal＂ （static and dynamic） cut-off valuesallowing to respond to all the still open questions in thisfield of transplant oncology.

关 键 词：ALPHA-FETOPROTEIN HEPATOCELLULAR cancer MILAN criteria Recurrence DROP-OUT 

分 类 号：R735.7[医药卫生—肿瘤]