Related Factors And Clinical Significance Of Carcinoembryonic Antigen Elevation In Patients With Hepatocellular Carcinoma

Objective: The relevant factors of carcinoembryonic antigen(CEA)for patients with hepatocellular carcinoma(HCC)and it's clinical significance for prognosis hepatocellular carcinoma(HCC)recurrence after treatment was analyzed.Methods: This study retrospectively collected clinical data of patients with HCC and treated in the Liver Research Center of the First Affiliated Hospital of Fujian Medical University from 2011 to 2018.The treatment methods included surgical operation,radiofrequency ablation,chemoembolization and seed implantation.The patients were divided into the CEA elevation group and the CEA normal group according to whether the CEA was increased in the follow-up,and the patients were divided into the radiofrequency ablation group and the non-radiofrequency ablation group according to whether the treatment included radiofrequency ablation.Clinical data,treatment methods,postoperative complications,follow-up time and recurrence were recorded.SPSS 25.0 software was used for analysis,and t test,u test and chi-square test were used to compare the differences in medical history and laboratory indexes of the study cases.Multiple Logistic regression analysis was used to discuss the relevant factors affecting CEA.COX survival regression was used to analyze the effect of CEA on the prognosis of liver cancer.P < 0.05 indicated that the difference was statistically significant.Accuracy,sensitivity,specificity,positive predictive value,and negative predictive value were used to evaluate the efficacy of CEA and alpha fetoprotein(AFP)monitoring after liver cancer treatment.Results: Of 85 HCCs,66 demonstrated normal CEA while 19 of elevation CEA.CEA normal group of patients with liver cirrhosis and higher recurrence rate after treatment were higher than CEA group,the differences were statistically significant(P < 0.05),while in age,sex,smoking history,drinking history,basic liver disease,CTP score,treatment,operation,tumor number,tumor size,tumor markers,based on the liver and kidney function,blood coagulation function,there was no statistically significant difference(P > 0.05).Among the 85 patients with liver cancer after treatment,59 patients did not show CEA elevation,accounting for 69.4%,7 patients showed onetime elevation,accounting for 8.2%,and 19 patients showed more than two elevation,accounting for 22.4%.Multiple Logistic regression analysis indicated that there was no linear relationship between AFP,TBil,ALB,ALT,AST,Cr,PT,INR and CEA after treatment(P < 0.05).COX regression analysis demonstrated that patients with increased CEA had a lower risk of liver cancer recurrence.Among the patients without recurrence,there was no statistically significant difference in the incidence of other tumors,gastric precancerous lesions,intestinal polyps,and pulmonary nodules between the normal CEA group and the elevated CEA group(P < 0.05).At the cutoff level of 5.2ng/ml(6.5ng/ml for smokers),the accuracy of predicting no recurrence of HCC was 52.94%,the sensitivity was 28.26%,the specificity was 82.05%,the positive predictive value was 65.00%,and the negative predictive value was 49.23%.At the truncation level of 35ng/ml,the accuracy of predicting no recurrence of HCC was 52.94%,the sensitivity was 15.22%,the specificity was 97.44%,the positive predictive value was 87.50%,and the negative predictive value was 49.35%.In comparison,the AFP value at the followup 3 months after surgery was used as the index.At the truncation level of 13.6ng/ml,the accuracy of predicting liver cancer recurrence was 64.71%,the sensitivity was 38.46%,the specificity was 32.61%,the positive predictive value was 71.43%,and the negative predictive value was 62.50%.At the cut-off level of 50ng/ml,the accuracy of predicting HCC recurrence was 60.00%,the sensitivity was 25.64%,the specificity was 21.74%,the positive predictive value was 66.67%,and the negative predictive value was 58.57%.Conclusion: Before treatment,CEA,AFP,CA125,CA199,tumor size,liver and kidney function,after treatment,AFP,liver and kidney function,surgical complications,and gastroscopic precancerous lesions are not related factors affecting CEA elevation after radiofrequency ablation.Patients with elevated CEA after radiofrequency ablation have a lower risk of recurrence.As an indicator with high specificity and high positive predictive value,CEA has low sensitivity and accuracy due to its low negative prediction.It has certain clinical significance in predicting the non-recurrence of liver cancer after radiofrequency ablation treatment,but has no significant value in predicting the recurrence of other liver cancer treatment methods.