Abstract

Background/AimsDespite great progress in the treatment of hepatocellular carcinoma (HCC) over the last-decade, intrahepatic recurrence is still the most frequent serious adverse event after all the treatments including microwave ablation. This study aimed to predict early recurrence of HCC after microwave ablation using serum proteomic signature.MethodsAfter curative microwave ablation of HCC, 86 patients were followed-up for 1 year. Serum samples were collected before microwave ablation. The mass spectra of proteins were generated using surface-enhanced laser desorption/ionization time-of-flight mass spectrometry (SELDI-TOF MS). Serum samples from 50 patients were randomly selected as a training set and for biomarkers discovery and model development. The remaining serum samples were categorized for validation of the algorithm.ResultsAccording to preablation serum protein profiling obtained from the 50 HCC samples in the training set, nine significant differentially-expressed proteins were detected in the serum samples between recurrent and non-recurrent patients. Decision classification tree combined with three candidate proteins with m/z values of 7787, 6858 and 6646 was produced using Biomarker Patterns Software with sensitivity of 85.7% and specificity of 88.9% in the training set. When the SELDI marker pattern was tested with the blinded testing set, it yielded a sensitivity of 80.0%, a specificity of 88.5% and a positive predictive value of 86.1%.ConclusionsDifferentially-expressed protein peaks in preablation serum screened by SELDI are associated with prognosis of HCC. The decision classification tree is a potential tool in predicting early intrahepatic recurrence in HCC patients after microwave ablation.

Highlights

  • Hepatocellular carcinoma (HCC) is an aggressive cancer with an overall poor prognosis

  • A major obstacle in HCC treatment is intrahepatic recurrence, which is high in patients who undergo hepatic resection [2,3]

  • Patients enrolled in the study fulfilled the following criteria: 1) single HCC nodule (#5 cm); 2) no portal thrombosis or extrahepatic metastases; 3) Child-Pugh class A or B; 4) histologically proven HCC; and 5) no treatment undertaken before Microwave ablation (MWA)

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Summary

Introduction

Hepatocellular carcinoma (HCC) is an aggressive cancer with an overall poor prognosis. A major obstacle in HCC treatment is intrahepatic recurrence, which is high in patients who undergo hepatic resection [2,3]. Microwave ablation (MWA), as a minimally invasive management technique, has been developed and improved greatly in the last few years. It has been widely used as an effective approach to HCC treatment in China because of its minimal damage to liver function, convenient manipulation, reduced complications, and lower mortality [4]. Despite complete ablation of the tumor, intrahepatic recurrence limits the potential therapeutic effect on HCC [5].

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