Association Between Multi-Laboratory Parameters Pre- and Post-Treatment and Pathological Features and Their Values in Clinical Decision in Primary Hepatic Carcinoma.

Abstract

Background: Primary hepatic cancer (PHC) is still a significant burden worldwide. The efficacy of diagnosis, treatment response monitoring, and prognostication using laboratory biomarkers is still a challenge. This study analyzed multi-laboratory parameters pre- and post-treatment and their associations with clinical and pathological features and clinical decisions in PHC patients to evaluate their clinical usefulness.

Methods: This study analyzed laboratory data from PHC patients by comparing changes between pre- and post-treatment and the efficacy of commonly used tumor markers and their associations with clinical and pathological features. Data from 441 PHC patients were analyzed.

Results: Serum alpha-fetoprotein (AFP) and alpha-L-fucosidase (AFU), alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyltransferase (γ-GT), indirect bilirubin (IBIL), and hepatitis B virus DNA (HBV DNA) were reduced after treatment; AFP, carcinoembryonic antigen (CEA), and cancer antigen 19-9 (CA-199) showed value in assisting the judgment of surgical resection; serum ferritin increased significantly along with stage advanced. AFP, CEA, CA-199, and ferritin were lower in surgical resection patients than non-surgical patients. A significant association was displayed between AFP levels and multiple biomarkers and clinical features when AFP cut-off was adjusted to 140 ng/mL. AFP was increased in PHC patients with chronic hepatitis B infection and liver cirrhosis, while CA-199 was decreased in both situations.

Conclusions: Tumor marker AFP, CEA, CA-199, serum chemistry test panel AFU, ALT, AST, γ-GT, bilirubin, protein, and HBV DNA are useful indicators in monitoring therapeutic response and disease progression and may be used as indicators in assisting the judgment of surgical resection of PHC.