Evaluation of Tumor Response Using Alpha-fetoprotein and Des-gamma-carboxy Prothrombin in Hepatocellular Carcinoma Patients Who Underwent Transarterial Chemoembolization

Cerban, Răzvan; Ester, Carmen; Iacob, Speranta; Paslaru, Liliana; Dumitru, Radu; Grasu, Mugur; Constantin, Georgiana Bianca; Popescu, Irinel; Gheorghe, L.

doi:10.21614/chirurgia.113.4.524

Cited by 7 publications

(5 citation statements)

References 20 publications

(21 reference statements)

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“…Our results show that changes in serum PIVKA-II levels track concordantly with treatment response in the majority of patients, across a wide range of treatment modalities. Our results in a Western cohort are consistent with the previous findings reported from Asian cohorts and are also consistent with a recent prospective study from a European cohort [ 14 – 18 , 26 , 27 ]. Collectively, the available evidence therefore confirms the value of PIVKA-II as a biomarker of tumour response across all stages of HCC, irrespective of disease aetiology.…”

Section: Discussionsupporting

confidence: 93%

The potential of PIVKA-II as a treatment response biomarker in hepatocellular carcinoma: a prospective United Kingdom cohort study

et al. 2021

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Section: Discussionsupporting

confidence: 93%

The potential of PIVKA-II as a treatment response biomarker in hepatocellular carcinoma: a prospective United Kingdom cohort study

et al. 2021

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“…The serum concentration of PIVKA II increased at higher BCLC staging, but AFP levels had no correlation with tumor stage. This finding might be explained by the fact that, as previously reported, tumor diameter is significantly correlated with PIVKA II levels (28).…”

Section: Male Predominance In Hcc Development May Besupporting

confidence: 57%

Evaluation of Alpha-fetoprotein and Prothrombin Induced by Vitamin K Absence for Hepatocellular Carcinoma Diagnosis in Patients Admitted to a Large Transplant Center

Cerban¹,

Ester²,

Iacob³

et al. 2018

SGO

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Background & aims: Prothrombin induced by vitamin K absence-II (PIVKA II) is a diagnostic marker and a major prognostic factor for hepatocellular carcinoma (HCC) with limited experience in European patients. The aim of this study was to investigate the clinical utility of simultaneous measurement of alphafetoprotein (AFP) and PIVKA II for hepatocellular carcinoma (HCC) diagnosis. Methods: In a Romanian cohort, we performed a case-control study to compare the performances of AFP and PIVKA-II serum levels for HCC diagnosis. To determine the diagnostic value of both biomarkers in distinguishing HCC from liver cirrhosis, receiver operating characteristic (ROC) curves were constructed for each biomarker and their combination. Results: From January 2016 to December 2017, 54 cirrhotic patients and 59 HCC cases were prospectively included. ROC curve analysis showed that 63 mAU/mL and 6 ng/mL were the optimal cutoff values for PIVKA-II and AFP respectively for diagnosis of HCC in our cohort. For HCC diagnosis in patients with AFP levels <20 ng/mL, the combination of AFP and PIVKA II had a specificity of 93.8% vs. 68.8 for AFP (AUC 0.846 vs. 0.732 respectively) (p=0.03). For the diagnosis of early HCC, the combination of AFP and PIVKA-II had a sensitivity of 72.7% and a specificity of 90.9% vs. 69% and 75% for AFP (AUC 0.867 vs. 0.825, respectively). Conclusion: The diagnostic performance of a combination of AFP and PIVKA II is better to that of either marker alone, in the diagnosis of HCC especially in patients with AFP levels <20 ng/mL and in patients with early tumors.

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“…Regarding clinical factors, we found that tumor size, but not AFP, was significantly associated with the initial treatment response, which was consistent with a previous study ( 31 ). The high baseline levels of AFP (> 20 ng/mL) may not be related to the initial therapy response, but several studies have reported that the AFP decline was associated with treatment response and significantly improved median survival in intermediate-stage HCC after TACE therapy ( 32 – 34 ). Tumor number is an uncertain predictive biomarker of treatment response in different centers, and the outcome needs more studies for confirmation ( 35 , 36 ).…”

Section: Discussionmentioning

confidence: 99%

Predicting the Initial Treatment Response to Transarterial Chemoembolization in Intermediate-Stage Hepatocellular Carcinoma by the Integration of Radiomics and Deep Learning

Peng

Huang

et al. 2021

Front. Oncol.

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ObjectivesWe aimed to develop radiology-based models for the preoperative prediction of the initial treatment response to transarterial chemoembolization (TACE) in patients with hepatocellular carcinoma (HCC) since the integration of radiomics and deep learning (DL) has not been reported for TACE.MethodsThree hundred and ten intermediate-stage HCC patients who underwent TACE were recruited from three independent medical centers. Based on computed tomography (CT) images, recursive feature elimination (RFE) was used to select the most useful radiomics features. Five radiomics conventional machine learning (cML) models and a DL model were used for training and validation. Mutual correlations between each model were analyzed. The accuracies of integrating clinical variables, cML, and DL models were then evaluated.ResultsGood predictive accuracies were showed across the two cohorts in the five cML models, especially the random forest algorithm (AUC = 0.967 and 0.964, respectively). DL showed high accuracies in the training and validation cohorts (AUC = 0.981 and 0.972, respectively). Significant mutual correlations were revealed between tumor size and the five cML models and DL model (each P < 0.001). The highest accuracies were achieved by integrating DL and the random forest algorithm in the training and validation cohorts (AUC = 0.995 and 0.994, respectively).ConclusionThe radiomics cML models and DL model showed notable accuracy for predicting the initial response to TACE treatment. Moreover, the integrated model could serve as a novel and accurate method for prediction in intermediate-stage HCC.

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Evaluation of Tumor Response Using Alpha-fetoprotein and Des-gamma-carboxy Prothrombin in Hepatocellular Carcinoma Patients Who Underwent Transarterial Chemoembolization

Abstract: There was a significant decrease of AFP and DCP values after complete response in HCC patients treated with TACE. DCP is a more effective tumor marker in predicting response than AFP, with no benefit found in their combination.

Cited by 7 publications

References 20 publications

The potential of PIVKA-II as a treatment response biomarker in hepatocellular carcinoma: a prospective United Kingdom cohort study

The potential of PIVKA-II as a treatment response biomarker in hepatocellular carcinoma: a prospective United Kingdom cohort study

Evaluation of Alpha-fetoprotein and Prothrombin Induced by Vitamin K Absence for Hepatocellular Carcinoma Diagnosis in Patients Admitted to a Large Transplant Center

Predicting the Initial Treatment Response to Transarterial Chemoembolization in Intermediate-Stage Hepatocellular Carcinoma by the Integration of Radiomics and Deep Learning

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