Introduction: Molecular targeting drugs are recommended as second-line treatment for intrahepatic advanced hepatocellular carcinoma (HCC). However, in Asia, hepatic arterial infusion chemotherapy (HAIC) is also considered as a second-line treatment because it improves the survival of responders. The aim of this study was to predict responders and non-responders to HAIC with low-dose cisplatin plus 5-fluorouracil (LFP) using tumor markers. Objective and Methods: The data of 47 patients who received LFP for the first time in our hospital were analyzed retrospectively. We evaluated the association between treatment response by Response Evaluation Criteria in Solid Tumors and the changing ratio of the serum concentration of α-fetoprotein (AFP), Lens culinaris agglutinin-reactive fraction of AFP (AFP-L3), and des-γ-carboxy prothrombin (DCP) 2 weeks after LFP initiation. Results: The number of patients showing a complete response (CR), a partial response (PR), stable disease (SD), and progressive disease (PD) was 0 (0%), 20 (43%), 18 (38%), and 9 (19%), respectively. The AFP ratio showed significant positive correlations for PR vs. SD (p = 0.004) and PR vs. PD (p = 0.003). The DCP ratio correlated significantly for PR vs. SD (p = 0.02). The optimal cutoff values for responders were 0.79 for the AFP ratio and 0.53 for the DCP ratio. Prediction using both or either cutoff value showed 93% sensitivity, 53% specificity, a 94% negative predictive value, and a 57% positive predictive value. Conclusion: Optimal cutoff values for AFP and DCP ratios enable prediction of nonresponders to HAIC with LFP. This simple and early assessment method allows the use of HAIC and molecular targeting drugs for HCC treatment.
Gastrointest Tumors

中文翻译：

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α-胎蛋白和脱-γ-羧基凝血酶的早期下降预测肝细胞癌患者肝动脉输注化疗的反应。

简介：分子靶向药物被推荐作为肝内晚期肝细胞癌（HCC）的二线治疗。然而，在亚洲，肝动脉灌注化疗（HAIC）也被认为是二线治疗，因为它可以提高反应者的生存率。本研究的目的是使用肿瘤标志物预测低剂量顺铂加 5-氟尿嘧啶 (LFP) 对 HAIC 的反应者和无反应者。目的与方法：回顾性分析我院首次接受LFP治疗的47例患者资料。我们通过实体瘤反应评估标准评估了治疗反应与甲胎蛋白（AFP）血清浓度变化率之间的关联， Lens culinaris在 LFP 启动后 2 周，AFP 的凝集素反应部分 (AFP-L3) 和去-γ-羧基凝血酶 (DCP)。结果：显示完全缓解 (CR)、部分缓解 (PR)、疾病稳定 (SD) 和疾病进展 (PD) 的患者数量分别为 0 (0%)、20 (43%)、18 (38%) ) 和 9 (19%)。AFP 比率显示 PR 与 SD ( p = 0.004) 和 PR 与 PD ( p = 0.003) 显着正相关。PR 与 SD 的 DCP 比率显着相关（p = 0.02）。响应者的最佳截止值为 AFP 比率为 0.79，DCP 比率为 0.53。使用两个或任一截止值进行预测显示出 93% 的敏感性、53% 的特异性、94% 的阴性预测值和 57% 的阳性预测值。结论： AFP 和 DCP 比率的最佳截止值能够预测对 LFP 的 HAIC 无反应者。这种简单和早期的评估方法允许使用 HAIC 和分子靶向药物治疗 HCC。
胃肠肿瘤