Clinical significance of serum ESM-1 levels in predicting early recurrence after radiofrequency ablation in patients with hepatocellular carcinoma

ZHONG Weiming; WU Yinya; DUAN Houzhang; LIU Lei; CAI Jingzhi

doi:10.3969/j.issn.1009-0460.2023.10.009

Abstract：Objective To investigate the relationship between serum specific molecule 1(ESM-1)and early recurrence after radiofrequency ablation(RFA)in patients with hepatocellular carcinoma(HCC).Methods The medical records of 459 HCC patients who received RFA treatment in our hospital from August 2017 to September 2022 were collected.Use sandwich enzyme-linked immunosorbent assay to detect serum ESM-1 levels.Follow up the early recurrence status of the patient within 2 years after the first treatment,and record the survival time after recurrence(PRS).The diagnostic efficacy of using receiver operating characteristic(ROC)curves to evaluate serum ESM-1 levels for predicting early recurrence risk in HCC patients after RFA treatment.Logistic regression analysis of factors affecting early recurrence in HCC patients after RFA treatment.Kaplan-meier plotted the PRS curve and performed a log rank test for differences.Results As of September 30,2022,a total of 366 patients(79.74%)experienced recurrence,of which 264 had early recurrence(≤2 years)and 102 had late recurrence(＞2 years).The median PRS of early recurrent HCC patients was significantly lower than that of late recurrent HCC patients(2.94 years vs.4.01 years,P＜0.05).The serum ESM-1 level of HCC patients in the recurrent group was 14.71 ng/ml(8.28,31.92),significantly higher than the 7.91 ng/ml(4.13,12.79)in the non recurrent group,and the difference was statistically significant(P＜0.05).The serum ESM-1 level in early recurrent patients was 18.65 ng/ml(9.67,33.12),significantly higher than the 9.41 ng/ml(5.33,21.01)in late recurrent patients,with a statistically significant difference(P＜0.05).The ROC curve result showed that serum ESM-1 levels can effectively predict the risk of early recurrence in HCC patients after RFA treatment,with an area under the curve(AUC)of 0.753(95%CI:0.693-0.812,P＜0.05).Logistic regression analysis showed that the number of lesions(P＜0.05)and serum α The levels of alpha fetoprotein(P＜0.05)and serum ESM-1(P＜0.05)are independent factors that affect early recurrence in HCC patients after RFA treatment.Among HCC patients with early recurrence after RFA treatment,patients with high serum ESM-1 levels had a shorter median PRS(1.40 years vs.3.86 years,P＜0.05).In early recurrent HCC patients with normal AFP,the median PRS was shorter in the group with high serum ESM-1 levels(2.19 years vs.4.67 years,P＜0.05).Conclusion Serum ESM-1 can serve as a predictive biomarker for early postoperative recurrence of RFA in HCC patients.