Changes In AFP?DCP And GP73 After TACE Combined With Apatinib On Patients With HBV-related Hepatocellular Carcinoma And Significance

BackgroundHepatocellular carcinoma(HCC)is a common malignant tumor in China.Transcatheter arterial chemoembolization(TACE)combined with small molecule anti-angiogenic targeting drugs is an important treatment for the treatment of HBV-related advanced hepatocellular carcinoma.The main oncological marker of liver cancer,alpha-fetoprotein(AFP),is a relatively specific serological marker.However,the sensitivity is low,and it has no diagnostic significance for AFP-negative patients.AFP is still negative in about 30% of patients with hepatocellular carcinoma in China.This part of the patient is difficult to use AFP for diagnosis and efficacy evaluation.In recent years,more and more tumor markers have been used in the diagnosis and evaluation of hepatocellular carcinoma,which has become a research hotspot.However,no diagnostic markers have been recognized,and combined detection has become a trend in diagnosis and monitoring.ObjectiveTo explore the changes of serum AFP,DCP and GP73 levels in patients with HBV-associated hepatocellular carcinoma before and after treatment with TACE combined with small molecule anti-angiogenic targeting drug(apatinib),and to predict the therapeutic value of serum AFP.The correlation between the expression levels of DCP and GP73 and the imaging of the same period,and the value of the changes of the three levels in the evaluation of efficacy.MethodsSelected 40 cases from the Infectious Department of the First Affiliated Hospital of Xinxiang Medical University from January 2018 to December 2018,which are an average age of 50.40±11.015 years,including 34 males and 6 females.According to mRECIST staging,the degree of tumor remission in TACE treatment was evaluated.The CR+PR grade was classified as the remission group,the SD+PD grade was the non-remission group,26 patients in the remission group and 14 patients in the non-remission group.There were no significant differences in age,gender,Child-Pugh classification,portal vein tumor thrombus and ALT between the two groups(P>0.05)).All the blood samples detected serum AFP?DCP and GP73 concentration.All subjects were hospitalized with 4 mL of venous blood in the early morning aseptic operation,accelerating tube collection,centrifugation at 3000 rpm for 10 min,serum was taken to another clean EP tube,placed in a-80? refrigerator,and then serum DCP and GP73 were performed ELISA detection.Statistical experimental data were used to analyze the changes of serum AFP,DCP and GP73 levels before and after TACE combined with apatinib and the predictive value of the therapeutic effect on patients with HBV hepatocellular carcinoma using SPSS21.0 software.Results1.There was no correlation between serum DCP,GP73 and AFP before TACE.Serum GP73 was negatively correlated with ALB and positively correlated with ALT and TBil(P < 0.05).There was no significant correlation between serum DCP and Alb,ALT,TBil(P > 0.05).2.There were no significant differences in AFP,DCP and GP73 between the two groups before treatment(P>0.05).The levels of AFP,DCP and GP73 in the remission group were lower than those in the non-remission group(P<0.05).There were significant differences between the ? AFP,? DCP and ? GP73 groups in the remission group(P<0.05).There were significant differences in the ? AFP%,? DCP% and ? GP73% between the remission group and the non-remission group(P<0.05).3.There was a significant negative correlation between mRECIST staging and ? AFP,? DCP and ? GP73(P<0.05).?4.AFP% used in the diagnosis and remission group under the ROC curve is 0.769,? DCP% is 0.904,? GP73% is 0.849,? AFP%+? DCP% is 0.860,? AFP%+? GP73% is 0.843,? AFP%+? DCP%+? GP73% is 0.940,and ? AFP%+? DCP%+? GP73% has the highest diagnostic value.Conclusion1.Serum DCP and GP73 were highly expressed in HBV-associated hepatocellular carcinoma patients,and had no significant correlation with AFP.2.Combined detection of changes in serum AFP,DCP,and GP73 levels in patients with hepatocellular carcinoma after hepatic arterial chemoembolization combined with apatinib treatment can be used to evaluate the efficacy.