Clinical Study Of Correlation Between Tumor Response And Dynamic Change Of AFP Value After Using The Particles TACE For Treating The Hepatocellularcarcinoma With Negative AFP

Objective:To investigate the correlation between the dynamic change of AFP and tumor response(m RECIST) with the AFP negative(less than 20 ng/m L) hepatocellular carcinoma(HCC) after gelatin sponge microparticles-transcatheter hepatic arterial chemoembolization(GSMs-TACE). Methods:To make a retrospective analysis of hepatocellular carcinoma patients who were hospitalized in Department of interventional therapy of Dalian University affiliated Zhongshan Hospital from January 2011 to September 2014. 35 cases conformed to the standard(AFP≤20 ng/m L) and marked as group A; group B(20<AFP≤400 ng/m L) in 31 cases. All TACE treated patients were used gelatin sponge microparticles(GSMs) as embolic agent. The changes in the level of AFP were evaluated on 4d, 7d and 30 d after GSMs-TACE, respectively, and midsection CT scan were reviewed on 4d, midsection enhanced CT or MRI were reviewed on 30 d too. Tumor response according to modified response evaluation criteria in solid tumors(m RECIST 1.1) was evaluated in 30 d after GSMs-TACE. T test and chi square test were applied for two groups of basic clinical data for statistical analysis.The change of AFP levels between preoperative and 30 d in postoperative were analyzed by T test and Wilcoxon signed rank test. Chi square test was used to determine correlation between tumor response and the changes in AFP after 30 d from GSMs-TACE postoperative. Analysised the correlation between the relative change of AFP and the change of tumor response after GSMs-TACE using Pearson correlation tests. Results:The dynamic changes of AFP value before and after the GSMs-TACE were detected in group A and B. Changes in AFP value of sub-group CR, PR, ORR before and 30 d after GSMs-TACE were statistical significance difference in two groups(P < 0.05). The changes of AFP of sub-group SD and PD in group A and sub-group PD in group B were not significant(P > 0.05). In group A and B, the comparison among proportion of CR, PR, SD, PD, tumor response on 30 d after GSMs-TACE, had no statistically significant(P > 0.05). Pearson correlation analysis showed that the changes of AFP value and tumor response(m RECIST) of groups A and B were positively correlated(r=0.8735, P<0.001 VS r=0.8449, P<0.001) at 30 d after GSMs-TACE. Before and 30 d after GSMs-TACE, TBIL,ALB, ALT in groups A, B and AST in group B were not statistically significant(P > 0.05); Group A has statistical significance of AST before and 30 d after the GSMs-TACE, the AST value decreased(P < 0.05). Conclusion: Positive correlation is shown between the change in the level of AFP and tumor response before and 30 d after GSMs-TACE in AFP negative HCC group, the level of AFP can be used as evaluation index of tumor response when the level of AFP is less than 20 ng/m L as same as HCC patient with positive AFP.