The predictive value of preoperative serum hsa_circ_0005397,AFP and CEA levels for the early recurrence after hepatocellular carcinoma surgery

SUN Yan; CHEN Wenjuan; XIE Cuihua; XIE Huiqin; JIANG Yan; ZONG Weiwei; FAN Meichen

doi:10.3969/j.issn.1674-4136.2025.06.013

Abstract：Objective To explore the clinical value of preoperative serum hsa_circ_0005397,alpha-fetoprotein(AFP)and carcinoembryonic antigen(CEA)in predicting the early recurrence after hepatocellular carcinoma(HCC)surgery.Methods A total of 125 patients who underwent laparoscopic radical resection of HCC in Rugao Hospital of Traditional Chinese Medicine from January 2020 to June 2023 were included.According to with or without recurrence in the early postoperative period(＜2 years),they were divided into the recurrence group and the non-recurrence group.The general information,tumor information,and preoperative serum-related indicators of the two groups were compared.Logistic regression was used to analyze the risk factors for early recurrence after HCC surgery.Based on this,a prediction model was constructed,and the predictive value of serum hsa_circ_0005397,AFP,and CEA levels for early recurrence was analyzed through the receiver operating characteristic(ROC)curve.Spearman correlation coefficient analysis was performed to explore the relationship between hsa-circ-005397 level and clinical pathological characteristios.Results The early postoperative recurrence rate of 125 HCC patients was 36%.The levels of hepatitis B virus(HBV)-DNA≥500 Iku/L,the tumor size≥5 cm,satellite nodules,BCLC stage B-C,microvascular invasion(MVI)rate,and preoperative serum hsa_circ_0005397,AFP and CEA levels in the recurrence group were significantly greater than those in the non-recurrence group(P＜0.05).Logistic regression analysis showed that the levels of MVI(OR=16.650),high serum hsa_circ_0005397(OR=68.856),AFP(OR=1.014),and CEA(OR=1.463)were independent risk factors affecting the early recurrence after HCC surgery(P＜0.05).The risk model of early recurrence after HCC surgery was constructed based on the independent influencing factors obtained from Logistic regression analysis(P)=-15.866+2.736×MVI+3.215×hsa_circ_0005397+0.011×AFP+0.408×CEA,and its area under the curve(AUC)for predicting early recurrence was 0.941.Hosmer-Lemeshow χ2=6.345,P＞0.05;Decision curve analysis showed that the threshold probability(red line)was distributed to the upper right of the None and All lines.The ROC curve showed that the AVC of preoperative serum hsa_circ_0005397,AFP,CEA and their combination for predicting early postoperative recurrence were 0.864,0.870,0.753 and 0.930,respectively.Preoperative serum hsa_circ_0005397 was positively correlated with tumor size,BCLC stage and MVI(all P＜0.001).Conclusions Preoperative serum hsa_circ_0005397,AFP and CEA all have certain predictive values for the early recurrence after HCC surgery.Especially the combined detection has a better predictive efficacy.Moreover,the risk prediction model constructed based on preoperative serum indicators and MVI has good discrimination,calibration ability and clinical practicability.