A high value of serum des-γ-carboxy prothrombin before hepatocellular carcinoma treatment can be associated with long-term liver dysfunction after treatment
Journal of Gastroenterology,  Clinical Article

Saito M et al. – High values of des–γ–carboxy prothrombin (DCP) and lactate dehydrogenase (LDH) before Transcatheter arterial chemoembolization (TACE) were associated with the long–term deterioration of liver function. The pre–therapeutic prediction model could be useful to identify high–risk cases.

Methods
  • The authors performed a case–control study in 100 HCC patients who underwent TACE at Kobe University Hospital.
  • Urinary/blood biochemical examinations were performed before TACE.
  • As an indicator of liver function, Child’s score was also evaluated before and 3 months after TACE.
  • Cases with and without an increase of 2 points or more in the Child’s score were compared, and independent risk factors were statistically examined.
  • A pre-TACE predictive model of an increase of 2 points or more in the Child’s score after TACE was developed using logistic regression.

Results
  • Univariate analyses showed that des-;γ-carboxy prothrombin (DCP) and lactate dehydrogenase (LDH) before TACE were significantly higher in the Child’s score-deteriorated group than in the group with no deterioration (p=0.036 and 0.003, respectively).
  • All possible multivariate regressions showed that DCP (p=0.003) and LDH (p=0.002) were independent factors determining the deterioration of Child’s class.
  • A predictive model was developed, as follows: exp(0.014 × LDH + 0.572 × ln(DCP) -8.655)/(1 + exp(0.014 × LDH + 0.572 × ln(DCP) - 8.655)).
  • The model discriminated well, with AUC being 0.837 (95 % confidence interval [CI] 0.662-1.000).
  • The optimal cut-off point was 0.073, and the sensitivity and specificity were 90.9 and 69.7 %, respectively.

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