Value of abnormal prothrombin in evaluating the short-term efficacy of transcatheter arterial chemoembolization in patients with hepatocellular carcinoma

Cha JunHao; Guo JinHe

doi:10.3969/j.issn.1001-5256.2020.09.016

Volume 36 Issue 9

Sep. 2020

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Article Navigation > Journal of Clinical Hepatology > 2020 > 36(9): 1990-1993

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Value of abnormal prothrombin in evaluating the short-term efficacy of transcatheter arterial chemoembolization in patients with hepatocellular carcinoma

DOI: 10.3969/j.issn.1001-5256.2020.09.016

Medical School, Southeast University

Research funding:

Published Date: 2020-09-20

Abstract

Abstract

Objective To investigate the value of abnormal prothrombin [protein induced by vitamin K absence or antagonist-Ⅱ( PIVKA-Ⅱ) ]in monitoring the short-term efficacy of transcatheter arterial chemoembolization( TACE) in patients with hepatocellular carcinoma( HCC). Methods A retrospective analysis was performed for the clinical data of 114 patients with HCC who were admitted to Zhongda Hospital Affiliated to Southeast University from January to December,2019,and all patients received conventional TACE alone and had a baseline PIVKA-Ⅱ level of ≥40. 00 m AU/ml. Serological response of PIVKA-Ⅱ was observed before TACE and at 1,3,and 6 months after TACE and was compared with radiological response at the same time point( based on mRECIST guidelines). A Spearman correlation analysis was used to investigate the correlation between serological response and radiological response. The paired chi-square test was used to analyze the consistency between the sensitivity of serological response and that of radiological response. Radiological response was used as the gold standard to investigate the validity and reliability assessment indices of the serological response of PIVKA-Ⅱ． Results The patients enrolled in this study had a PIVKA-Ⅱ level of 7225. 44( 40. 13-30 000. 00) m AU/ml. At 1,3,and 6 months after TACE,104 patients( 91. 2%),94 patients( 90. 3%),and 86 patients( 90. 5%),respectively,had serological response,while 103 patients( 90. 3%),90 patients( 86. 5%),and 82 patients( 86. 3%) had radiological response. The Spearman correlation analysis showed that radiological response was positively correlated with serological response at 1,3,and 6 months after TACE( r = 0. 739,0. 731,and 0. 708,all P < 0. 001). The paired chi-square test showed that serological response and radiological response had a relatively consistent sensitivity in assessment at 1,3,and 6 months after TACE( χ2= 0,1. 5,and 1. 5,P = 1. 000,0. 219,and 0. 219). The validity and reliability assessment indices of serological response maintained at a relatively high level. Conclusion Based on the criteria for radiological response,PIVKA-Ⅱ has a good value in monitoring the short-term efficacy of TACE in patients with HCC.
- carcinoma,hepatocellular,
- chemoembolization,therapeutic,
- PIVKA-Ⅱ,
- treatment outcome

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References

[1] Bureau of Medical Administration,National Health Commission of the People’s Republic of China. Guidelines for diagnosis and treatment of primary liver cancer in China(2019 edition)[J]. J Clin Hepatol,2020,36(2):277-292.(in Chinese)中华人民共和国国家卫生健康委员会医政医管局．原发性肝癌诊疗规范(2019年版)[J]．临床肝胆病杂志，2020,36(2):277-292.

[2] HAN B,QI XS,JIA JD. Recommendations of the Asia-Pacific clinical practice guidelines on the management of hepatocellular carcinoma:A 2017 update[J]. J Clin Hepatol,2017,33(8):1432-1434.(in Chinese)韩冰，祁兴顺，贾继东．亚太肝细胞癌管理临床实践指南推荐意见(2017年更新版)[J]．临床肝胆病杂志，2017,33(8):1432-1434.

[3] European Association for the Study of the Liver. EASL clinical practice guidelines:Management of hepatocellular carcinoma[J]. J Hepatol,2018,69(1):182-236.

[4] Interventional Group,Chinese Society of Radiology,Chinese Medical Association. Expert consensus on technical operational standard of transcatheter arterial chemoembolization for primary hepatocellular carcinoma[J]. Chin J Radiol,2011,45(10):908-912.(in Chinese)中华医学会放射学分会介入学组协作组．原发性肝细胞癌经导管肝动脉化疗性栓塞治疗技术操作规范专家共识[J]．中华放射学杂志，2011,45(10):908-912.

[5] TORRE LA,BRAY F,SIEGEL RL,et al. Global cancer statistics,2012[J]. CA Cancer J Clin,2015,65(2):87-108.

[6] HE X,ZHAN MX,LU LG. Application of transcatheter arterial chemoembolization in treatment of hepatocellular carcinoma:Current status and perspectives[J/CD]. Chin J Inter Rad(Electronic Edition),2018,6(2):124-126.(in Chinese)何旭，占美晓，陆骊工．肝动脉化疗栓塞治疗肝细胞癌的应用现状与展望[J/CD]．中华介入放射学电子杂志，2018,6(2):124-126.

[7] LI JH,SHI ZR. Research progress on adjuvant transcatheter arterial chemoembolization in postoperative hepatocellular carcinoma[J]. China Med Herald,2020,17(3):34-37.(in Chinese)黎经何，史政荣．原发性肝癌术后辅助经导管动脉栓塞术的研究进展[J]．中国医药导报，2020,17(3):34-37.

[8] WANG YL,FANG N,ZENG L,et al. The value of18F-FDG PET/CT in transcatheter hepatic arterial chemoembolization therapy of primary hepatocellular carcinoma with high FDG uptake[J]. Chin J Nucl Med Mol Imaging,2013,33(5):328-331.(in Chinese)王艳丽，房娜，曾磊，等．18F-FDG PET/CT对高18F-FDG摄取肝细胞肝癌经动脉插管化疗栓塞的疗效评价[J]．中华核医学与分子影像杂志，2013,33(5):328-331.

[9] PARK H,PARK JY. Clinical significance of AFP and PIVKA-II responses for monitoring treatment outcomes and predicting prognosis in patients with hepatocellular carcinoma[J]. Biomed Res Int,2013,2013:310427.

[10] HIRAOKA A,ISHIMARU Y,KAWASAKI H,et al. Tumor markers AFP,AFP-L3,and DCP in hepatocellular carcinoma refractory to transcatheter arterial chemoembolization[J]. Oncology,2015,89(3):167-174.

[11] LENCIONI R,LLOVET JM. Modified RECIST(mRECIST)assessment for hepatocellular carcinoma[J]. Semin Liver Dis,2010,30(1):52-60.

[12] YAN CL,HU J,YANG J,et al. Serum ARCHITECT PIVKA-II reference interval in healthy Chinese adults:Sub-analysis from a prospective multicenter study[J]. Clin Biochem,2018,54:32-36.

[13] HEMKER HC,VELKAMP JJ,HENSEN A,et al. Nature of prothrombin biosynthesis:Preprothrombinmia in vitamin K-deficiency[J]. Nature,1963,200(11):589-590.

[14] YANG XX,MA H. Research advances in tumor markers of hepatocellular carcinoma[J]. J Clin Hepatol,2016,32(4):811-815.(in Chinese)杨霄霄，马红．肝细胞癌肿瘤标志物的研究进展[J]．临床肝胆病杂志，2016,32(4):811-815.

[15] SUN Y,ZHANG HH,YUAN CW,et al. Value of serum des-γ-carboxy-prothrombin in the diagnosis and treatment of hepatocellular carcinoma[J]. J Clin Hepatol,2018,34(10):2148-2152.(in Chinese)孙玉，张洪海，袁春旺，等．血清异常凝血酶原在肝细胞癌诊疗中的意义[J]．临床肝胆病杂志，2018,34(10):2148-2152.

[16] LEE HW,SONG GW,LEE SG,et al. Patient selection by tumor markers in liver transplantation for advanced hepatocellular carcinoma[J]. Liver Transpl,2018,24(9):1243-1251.

[17] REN W,YANG W. Radiofrequency ablation for the treatment of recurrent hepatocellular carcinoma:Analysis of the therapeutic results and prognostic factors[J]. J Intervent Radiol,2015,24(10):923-927.(in Chinese)任炜，杨薇．射频消融治疗复发性肝癌疗效及预后因素分析[J]．介入放射学杂志，2015,24(10):923-927.

[18] YOON SM,RYOO BY,LEE SJ,et al. Efficacy and safety of transarterial chemoembolization plus external beam radiotherapy vs sorafenib in hepatocellular carcinoma with macroscopic vascular invasion:A randomized clinical trial[J]. JAMA Oncol,2018,4(5):661-669.

[19] YUAN LW,TANG W,ZHOU JP,et al. Quantitative measurement of des-γ-carboxy-prothrombin in cancerous and non-cancerous liver tissue and its role in hepatocellular carcinoma[J]. World Chin J Dig,2006,14(1):45-49.(in Chinese)袁联文，唐伟，周建平，等．肝癌组织中脱-γ-羧基凝血酶原的测定及意义[J]．世界华人消化杂志，2006,14(1):45-49.

[20] VINCENZI B,DI MAIO M,SILLETTA M,et al. Prognostic relevance of objective response according to EASL criteria and mRECIST criteria in hepatocellular carcinoma patients treated with loco-regional therapies:A literature-based Meta-analysis[J]. PLo S One,2015,10(7):133488.

[21] LU FM. Serological diagnosis of hepatocellular carcinoma:Challenging and opportunities[J]. J Clin Hepatol,2017,33(7):1262-1265.(in Chinese)鲁凤民．肝细胞癌的血清学诊断-挑战与希望同在[J]．临床肝胆病杂志，2017,33(7):1262-1265.

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Value of abnormal prothrombin in evaluating the short-term efficacy of transcatheter arterial chemoembolization in patients with hepatocellular carcinoma

DOI: 10.3969/j.issn.1001-5256.2020.09.016