Dynamic Changes And Significance Of Hepatocellular Liver Cancer Patients Before And After Transcatheter Arterial Chemoembolization Of Serum GP73

Background:Hepatocellular Carcinoma (HCC) is one of the most malignent tumors, with morbility ranked as the5th and fatality as the3rd among all kinds of malignent tumors.lnfection of the hepatitis virus and alcohol abuse are two main risk factors for HCC and as China is an aera endemic for hepatitis B, HCC is very prevalent, causing great damage to the people’s health and heavy burden to the whole society.Because many diagnosis are made when the disease is advanced with obvious symptoms and impaired liver function, only small amount of the patients can be given curative treatments Transcatheter Arterial Chemoembolization (TACE) is an effective palliative treatments suggested by guidelines of HCC management. However, there still exists debate about the arrangement of TACE therapy.With the development of biologic technology, a series of new tumor markers for HCC have been discovered and Golgi Protein73(GP73) is a type II Golgi transmembrane protein,which turns out to be a predominant and promising member of this group. Ever since Block and his colleagues first demonstrated that serum GP73(sGP73) level was significantly increased in hepatocellular cancer patients, a great many clinical trials have been processed, which indicates the sensitivity and specificity of sGP73are both superior to those of AFP. However, up to now, most trials about GP73mainly are cross-section studies,and few have observed the dynamic change of sGP73. In our past multicentre study, we found that the sGP73level will descent after the surgical resection and will ascent with the recurrence of the tumor,indicating it may be valuable in assessing prognosis. Nevertheless, the dynamic change of sGP73in the process of treatment with other mechanisms,such as TACE, remains unkown.Purpose:This study aims to observe the dynamic change of sGP73of HCC patients in the process of TACE and evaluate the association between sGP73and the prognosis according to the change of imageology and AFP. Furthermore, we want to evaluate if sGP73is a valuable serum marker to predict recurrence and metastasis after TACE treatment. Materials and Methods: Blood samples were taken in58patients with HCC before TACE, and1day,4weeks after TACE and blood samples were also taken in90healthy people. The HCC patients were followed up after the first TACE and the imageologic and clinic data were collected. sGP73levels were measured by Western Blot.Results:The sGP73levels were significantly increased in HCC patients [4.6(3.1-7.4)] in contrast to healthy controls [1.3(1.0-2.1)](P<0.01). There was no correlation between sGP73levels and gender, age, infection of HBV, tumor number, tumor size, vascular invasion, lymphatic invasion, metastasis, AFP levels (P>0.05). The change of sGP73before and after TACE was also irrelevant with the factors above.After Spearman correlation analysis showed that sGP73correlated with ALB、AS、TBil、DBil、LDH before TACE,and with ALP, LDH after TACE (P<0.05). The sGP73levels significantly increased1day [5.3(3.4-8.3)]and1month[5.3(3.4-8.3)] after TACE in HCC patients (P<0.01) compared with before[4.6(3.4-7.3)], however there was no statistic difference between the former two. According to the RECIST standard, we divided the HCC patients into two groups:Processive Disease (n=6) and Stable Disease (n=30),however, there was no significant difference of sGP73changing rate between the two group. We also divided the patients according to the change of AFP, the result indicated no statistic difference of sGP73changing rate among the three groups. Finally,we observed the change of sGP73levels in8patients who underwent at least3TACE treatments. It turned out that in4of them the sGP73level descended before the3rd TACE compared with before the2nd TACE and the sGP73level befoer the3rd TACE seemed stable in the other4patients.Conclusion:Our study first observed the dynamic change of sGP73levels in HCC patients before and after TACE and demonstrated that sGP73level increased significantly after the treatment of TACE. The change of sGP73had no correlation with the change of imageology and AFP. The follow-up study indicated that sGP73level didnot increase with time but turned stable or descended, which might suggest it be associated with the cancer stem cell. However, whether sGP73can be a valuable serum marker to prodict the prognosis of TACE remained unknown, and futher follow-up studys are necessary.