Value of serum des-γ-carboxy-prothrombin in the diagnosis and treatment of hepatocellular carcinoma

Objective To investigate the expression of des-γ-carboxy-prothrombin ( DCP) in serum in hepatocellular carcinoma ( HCC) patients and its association with tumor properties, pathology, and clinical features. Methods A total of 80 patients who were hospitalized and treated in our hospital from January 2016 to March 2018 and were diagnosed with HCC by pathology after surgical resection were enrolled. The serum levels of DCP and alpha-fetoprotein ( AFP) were measured before surgery and the correlation between them was analyzed. The association of DCP level with clinical data, imaging findings, and pathological results was analyzed. Mann-Whitney U test was used for comparison of continuous data between two groups, Kruskal-Wallis H test was used for comparison between multiple groups, and the Mann-Whitney U test was used for further comparison between two groups; the Spearman correlation analysis was performed to investigate correlation. Results There was no significant correlation between the serum levels of AFP and DCP in HCC patients ( r = 0. 141, P >0. 05) . In HCC patients, serum DCP level was significantly correlated with tumor diameter ( r = 0. 563, P < 0. 01) . The HCC patients with intrahepatic multiple tumors, distant metastasis, or macrovascular or microvascular invasion had a significantly higher serum DCP level than those with intrahepatic single tumor ( Z =-5. 484, P < 0. 001) or without distant metastasis ( Z =-4. 569, P < 0. 001) , macrovascular invasion ( Z =-3. 713, P < 0. 001) , or microvascular invasion ( Z =-3. 244, P = 0. 001) . According to the staging criteria in China, the patients with stage Ⅰ HCC had a significantly lower serum DCP level than those with stage Ⅱ/Ⅲ HCC ( P = 0. 005 and P < 0. 001) , while there was no significant difference in serum DCP level between the patients with stage Ⅱ HCC and those with stage Ⅲ HCC ( P = 0. 477) .The patients with Edmondson-Steiner grade Ⅱ/Ⅲ HCC had a significantly lower serum DCP level than those with Edmondson-Steiner grade IV HCC ( P < 0. 001 and P = 0. 002) , while there was no significant difference in serum DCP level between the patients with Edmondson-Steiner grade Ⅱ HCC and those with Edmondson-Steiner grade Ⅲ HCC ( P = 0. 133) . Conclusion In HCC patients, serum DCP level is associated with number of tumors, tumor size, clinical stage, distant metastasis, vascular invasion, and pathological grade.