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

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.