The value of protein induced by vitamin K absence or antagonist-II (PIVKA) in predicting the efficacy of transhepatic arterial chemoembolisation (TACE): A retrospective study

TL;DR

This study shows that measuring specific blood markers before and after a liver cancer treatment can help predict how well the treatment is working.

Contribution

The study demonstrates that combining changes in AFP and DCP levels provides a more accurate prediction of TACE efficacy in HCC patients.

Findings

AFP and DCP levels significantly decreased in patients who responded well to TACE.

The combination of AAFP% and ADCP% had the highest diagnostic value with an area under the curve of 0.921.

Both AAFP and ADCP were negatively correlated with treatment response according to mRECIST criteria.

Abstract

To investigate the value of AFP combined with degamma-carboxylprothrombin (DCP), vitamin K absence or antagonist-II (PIVKA) in predicting the efficacy of transhepatic arterial chemoembolisation (TACE).

The clinical data of 69 patients with hepatocellular carcinoma (HCC) who received TACE at our hospital between March 2020 and December 2024 were retrospectively analysed. Changes in the serum AFP and DCP levels of patients before TACE and after two consecutive TACE operations were analysed. The therapeutic effect of TACE was evaluated using the MRECIST criteria. The changes in AFP and DCP levels were compared with the imaging data from the same period (mRECIST criteria). The measurement data were tested for normality, and comparisons between two groups that conformed to a normal distribution were performed using two-way independent sample t-tests. The Mann-Whitney U test was used to compare normally distributed data between the two groups. The c2 test was used to compare the counting data between the two groups, and the Mann-Whitney U test was used to compare the rank-counting data between the two groups. Spearman correlation analysis was used to explore the correlation between mRECIST grade and AFP and DCP levels. The value of each index in the diagnosis of patients in the remission group was analysed by subject working characteristic curve analysis.

According to the mRECIST criteria, 38 patients were in the remission group, and 31 were in the nonremission group. After treatment, the AFP and DCP levels in the remission group were significantly lower than those in the non-remission group (Z=-3.366 and -4.065, P<0.05). There were statistically significant differences in AAFP ADCP AAFP%, and ADCP% between the remission group and the nonremission group (Z=-4.837, -5.597, -4.210, and -5.851, respectively; P<0.001). The mRECIST stage was negatively correlated with AAFP and ADCP (RS = -0.552 and -0.593, P<0.001). The area under the working characteristic curve of AAFP% was 0.796, that of ADCP% was 0.912, that of AAFP% + ADCP% combined was 0.921, and that of AAFP% + ADCP% had the most significant diagnostic value.

A combined analysis of serum AFP and DCP levels before and after TACE can be used to evaluate the therapeutic effect of TACE in patients with hepatocellular carcinoma.

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