Research Of Em-cfDNA In The Efficacy Evaluation Of Microwave Ablation For Hepatic Alveolar Chinococcosis

Objective:To investigate the changes of circulating cell free DNA(Em-cfDNA)in alveolar echinococcosis(HAE)before and after microwave ablation(microwave ablation,MWA),and to determine whether Em-cfDNA can be regarded as a reference index for evaluating the efficacy of MWA in the treatment of HAE.Methods:14 patients with HAE were diagnosed by the Department of Hepatobiliary and Pancreatic surgery of the affiliated Hospital of Qinghai University from February 2019 to February 2022 were collected.The diameter of the lesions was≤5cm.one patient with hepatic hemangioma was confirmed by postoperative pathology,one patient who gave up treatment,and three patients who underwent surgical resection were excluded.A total of 9 patients finally met the inclusion and exclusion criteria.The whole blood samples of patients with HAE were collected before and after MWA.The plasma was separated,then Em-cfDNA in the plasma was detected by next-generation sequencing(NGS).The contents of Em-cfDNA were analyzed before and after MWA.Results:1.The average age of 9 subjects was 30.7±13.5 years old,six males and three females,with a total of 17 lessons,all of which ablated.2.5 cases had a positive Em-cfDNA test before the operation,3 cases had a positive Em-cfDNA test on the first day after the operation,and all cases had a negative Em-cfDNA test result on the third day after the operation.The level of Em-cfDNA after the operation was lower than before,and its difference was statistically significant(Z=-2.236,P=0.025).2.The level of alanine aminotransferase in 9 patients on the first day after the operation were higher than the level of alanine aminotransferase before the operation(Z=-2.666,P=0.008).Aspartate aminotransferase was higher after the operation(Z=-2.666,P=0.008),albumin had no significant difference(t=1.678,P=0.132),and total bilirubin was higher after the operation(t=-5.130,P=0.001).3.There was no significant correlation between the preoperative Em-cfDNA level and the preoperative ALT,ALB and TBI level(r_S=0.522,P=0.150;r_S=-0.346,P=0.361;r_S=0.173,P=0.656;).There had a significant positive correlation between the preoperative Em-cfDNA level and the preoperative AST level(r_S=0.870,P=0.002).4.No serious complications occurred after ablation.Conclusion:The level of Em-cfDNA after MWA in HAE was lower than those preoperative level,which can be regarded as a reference index for evaluating the efficacy of HAE after MWA treatment.