Change in serum level of abnormal prothrombin after microwave ablation for hepatocellular carcinoma and its clinical significance

Objective To investigate the changes in serum levels of des-γ-carboxy-prothrombin ( DCP) and alpha-fetoprotein ( AFP) after microwave ablation in patients with hepatocellular carcinoma ( HCC) , to monitor the recurrence of HCC, and to investigate the associa-tion of serum DCP and AFP levels with the recurrence of HCC. Methods A total of 76 patients who were hospitalized and treated in BeijingYouAn Hospital, Capital Medical University, from December 2015 to February 2018 and were diagnosed with HCC by liver biopsy were en-rolled. The serum levels of DCP and AFP were measured before and after microwave ablation and at the time of recurrence. The Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups, and the Kruskal-Wallis H testwas used for comparison between three groups; the Spearman correlation analysis was used to investigate correlation. Results At 1 week af-ter microwave ablation, the HCC patients had significant reductions in the serum levels of DCP and AFP ( Z = 6. 854 and 6. 246, both P <0. 01) , which further decreased at 1 month after microwave ablation ( DCP: Z = 11. 639 and 4. 786, both P < 0. 01; AFP: Z = 10. 058 and3. 812, both P < 0. 01) . Of all 76 HCC patients, 59 experienced recurrence, and the serum levels of DCP and AFP at the time of recurrencewere significantly higher than the levels at 1 week and 1 month after microwave ablation ( DCP: Z =-4. 671 and-8. 521, both P < 0. 01;AFP: Z =-3. 423 and-6. 311, both P < 0. 01) . Before microwave ablation, the recurrence group had significantly higher serum levels ofDCP and AFP than the non-recurrence group ( Z =-3. 010 and-2. 387, P = 0. 003 or P = 0. 017) ; at 1 month after microwave ablation, the recurrence group had a significantly higher serum level of DCP than the non-recurrence group ( Z =-3. 498, P < 0. 001) . In the re-currence group, the patients with extrahepatic distant metastasis or vascular invasion had a significantly higher serum level of DCP than thosewith intrahepatic recurrence alone before and at 1 month after microwave ablation ( χ2= 23. 597 and 18. 228, both P < 0. 01) . Correlation a-nalysis showed that in HCC patients with recurrence, serum DCP level before and at 1 month after microwave ablation was negatively correlated with time to recurrence ( r =-0. 500 and-0. 651, both P < 0. 01) . Conclusion Monitoring of serum DCP level before and after microwave ablation in HCC patients helps to judge the clinical effect of microwave ablation and predict recurrence and prognosis.