Changes in alpha-fetoprotein and des-γ-carboxy-prothrombin after transarterial chemoembolization and their value in predicting treatment outcome

Objective To investigate the value of alpha-fetoprotein (AFP) combined with des-γ-carboxy-prothrombin (DCP) in predicting the therapeutic effect of transarterial chemoembolization (TACE) .Methods A retrospective analysis was performed for the clinical data of 85 patients with hepatocellular carcinoma (HCC) who underwent TACE in The First Affiliated Hospital of Soochow University from October 2016 to March 2018.The serum levels of AFP and DCP were measured before TACE and after two consecutive sessions of TACE, and modified RECIST (mRECIST) was used to evaluate the therapeutic effect of TACE.The changes in AFP and DCP were compared with imaging findings based on mRECIST.The two-independent-samples t test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups.The chi-square test was used for comparison of categorical data between two groups, and the Mann-Whitney U test was used for comparison of ranked data between two groups.A Spearman correlation analysis was used to investigate the correlation of mRECIST category with AFP and DCP.The receiver operating characteristic (ROC) curve was used to investigate the value of each index in the diagnosis of remission.Results According to the mRECIST criteria, 38 patients achieved remission (remission group) and 31 did not achieve remission (non-remission group) .After treatment, the remission group had significantly lower AFP and DCP than the non-remission group (Z=-3.366 and-4.065, both P<0.05) .There were significant differences between the remission group and the non-remission group inΔAFP, ΔDCP, ΔAFP%, andΔDCP% (Z=-4.837, -5.597, -4.210, and-5.851, all P<0.001) .The mRECIST category was negatively correlated withΔAFP andΔDCP (rs=-0.552 and-0.593, both P<0.001) .In the diagnosis of remission, ΔAFP%had an area under the ROC curve (AUC) of 0.796, whileΔDCP%had an AUC of 0.912 andΔAFP%combined withΔDCP%had an AUC of0.921, suggesting thatΔAFP%combined withΔDCP%had the highest diagnostic value.Conclusion Changes in serum DCP and AFP after TACE can be used to evaluate the outcome of HCC after TACE.