Changes of serum tumor markers,inflammatory indexes and coagulation indexes in patients with hepatitis B virus-related hepatocellular carcinoma treated with TACE

Meng Lingyu; Liu Qiqi; Chen Jiaxin; Li Yadong; Zhang Linlin; Guan Rongchun; Zhao Wei

doi:10.3969/j.issn.1674-7151.2025.03.002

Abstract：Objective To investigate changes in serum alpha fetoprotein(AFP),neutrophil to lymphocyte ratio(NLR),platelet count(PLT)and coagulation parameters in patients with hepatitis B virus(HBV)-related hepatocellular carcinoma(HCC)after treatment.Methods The clinical data from 60 patients with HBV-related HCC admitted to interventional department of the Third Affiliated Hospital of Qiqihar Medical College from January 2022 to December 2023 were retrospectively analyzed.All patients underwent transcatheter arterial chemoembolization(TACE).The serum AFP was measured using chemiluminescence immunoassay.The parameters including white blood cells and PLT were detected using fluorescent flow cytometry,and NLR was calculated.The coagulation indicators[including fibrinogen(FIB),thrombin time(TT),prothrombin time(PT)and activated partial thromboplastin time(APTT)]were detected using automated coagulation analyzer.The changes in serum AFP,NLR,PLT and coagulation indicators before and after treatment were compared.The short-term efficacy was evaluated on day 30 post-treatment,and the patients were divided into disease controlled(DC)group(44 cases)and disease uncontrolled(non-DC)group(16 cases)based on the efficacy assessment results.The levels of serum AFP,NLR,PLT and coagulation indicators between two groups were compared.Spearman correlation analysis was used to investigate the correlation between serum AFP,NLR,PLT,coagulation indicators and short-term efficacy in patients with HBV-related HCC.Results On day 3 and day 30 post-treatment,the serum levels of AFP,NLR and FIB in patients with HBV-related HCC were significantly lower than those before treatment[AFP(μg/L):516.27±47.92,385.60±49.83 vs.582.71±56.19;NLR:3.57±0.62,2.49±0.58 vs.4.10±0.54;FIB(g/L):1.59±0.40,1.03±0.32 vs.3.10±0.72;all P<0.05].On day 3 post-treatment,the level of PLT was significantly lower than that before treatment,while the levels of TT,PT and APTT were significantly higher than those before treatment[PLT(×109/L):123.88±11.04 vs.137.75±11.27;TT(s):25.69±2.78 vs 22.75±3.14;PT(s):18.41±2.30 vs 15.08±2.16;APTT(s):45.19±5.65 vs 39.26±5.48;all P<0.05].On day 30 post-treatment,the level of PLT was higher than those before treatment and on day 3 post-treatment,while the levels of TT,PT and APTT were lower than those before treatment and on day 3 post-treatment[PLT(×109/L):148.97±10.05 vs.137.75±11.27,123.88±11.04;TT(s):15.08±2.59 vs.22.75±3.14,25.69±2.78;PT(s):10.61±1.85 vs.15.08±2.16,18.41±2.30;APTT(s):28.07±4.29 vs.39.26±5.48,45.19±5.65;all P<0.05].The DC group had significantly lower serum AFP,NLR,FIB,TT,PT and APTT levels,and significantly higher PLT level compared to non-DC group[AFP(μg/L):357.92±34.57 vs.410.58±32.15;NLR:2.31±0.30 vs.2.70±0.33;FIB(g/L):2.73±0.49 vs.3.42±0.51;TT(s):13.97±1.76 vs.16.24±1.85;PT(s):9.70±1.43 vs.11.59±1.36;APTT(s):26.02±3.10 vs.30.15±2.98;PLT(×109/L):126.79±5.47 vs 119.52±6.10;all P<0.05].Serum AFP,NLR,FIB,TT,PT and APTT showed negative correlations with short-term efficacy,while PLT showed a positive correlation(r values were-0.814,-0.839,-0.780,-0.841,-0.803,-0.785,0.769,P values were 0.004,0.003,0.005,0.003,0.004,0.005,0.006,respectively).Conclusions After TACE treatment in patients with HBV-related HCC,serum levels of AFP,NLR and FIB significantly decreased,the levels of TT,PT and APTT initially increased and then decreased,while the level of PLT initially decreased and then sincreased.Serum AFP,NLR,PLT and coagulation sparameters are closely associated with the short-term efficacy of TACE treatment and could assist in evaluating patients'prognosis.