Department of Gastroenterology, Nara Medical University, Kashihara, Nara 634-8522, Japan.
Department of Blood Transfusion Medicine, Nara Medical University, Kashihara, Nara 634-8522, Japan.
World J Gastroenterol. 2020 Dec 7;26(45):7232-7241. doi: 10.3748/wjg.v26.i45.7232.
Prediction of HAIC treatment response is important for improving the prognosis in patients with hepatocellular carcinoma (HCC). The progression of HCC is related to hypercoagulability and angiogenesis. It is known that ADAMTS13 and von Willebrand factor (VWF) are related to hypercoagulability. In addition, previous study reported that the association between ADAMTS13 and VWF, and angiogenesis vascular endothelial growth factor (VEGF). Recently, ADAMTS13 and VWF have been associated with the prognosis in patients with various kinds of cancer undergoing chemotherapy.
To investigate whether ADAMTS13 and VWF become useful biomarkers of treatment response in HCC patients before the initiation of HAIC treatment.
Seventy-two patients were enrolled in this study. ADAMTS13 activity (ADAMTS13:AC), VWF antigen (VWF:Ag) and VEGF levels were determined enzyme-linked immunosorbent assay. Univariable and multivariable analyses were performed to determine the predictive factors of treatment response in patients with HCC undergoing HAIC treatment.
ADAMTS13:AC levels in HCC patients with stable disease (SD) + partial response (PR) of HAIC treatment were significantly higher than those with progressive disease (PD) ( < 0.05). In contrast, VWF:Ag/ADAMTS13:AC ratio and VEGF levels in HCC patients with SD + PR were significantly lower than those with PD (both < 0.05). Patients with high VWF:Ag/ADAMTS13:AC ratio (> 2.7) had higher VEGF levels than those with low ratio (≤ 2.7). Multivariable analysis revealed that VWF:Ag/ADAMTS13:AC ratio was a predictive factor of HAIC treatment response.
VWF:Ag/ADAMTS13:AC ratio may become a useful biomarker of treatment response in HCC patients before the initiation of HAIC treatment.
预测肝癌（HCC）患者肝动脉化疗栓塞（HAIC）治疗反应对于改善预后很重要。HCC 的进展与高凝状态和血管生成有关。已知 ADAMTS13 和血管性血友病因子（VWF）与高凝状态有关。此外，先前的研究报道 ADAMTS13 与 VWF 之间存在关联，以及与血管生成有关的血管内皮生长因子（VEGF）。最近，ADAMTS13 和 VWF 与接受各种化疗的癌症患者的预后有关。
探讨 ADAMTS13 和 VWF 是否可作为 HCC 患者在接受 HAIC 治疗前预测治疗反应的有用生物标志物。
本研究共纳入 72 例患者。采用酶联免疫吸附试验测定 ADAMTS13 活性（ADAMTS13:AC）、VWF 抗原（VWF:Ag）和 VEGF 水平。采用单变量和多变量分析确定接受 HAIC 治疗的 HCC 患者的治疗反应预测因素。
HAIC 治疗稳定疾病（SD）+部分缓解（PR）的 HCC 患者 ADAMTS13:AC 水平显著高于进展疾病（PD）患者（<0.05）。相比之下，SD+PR 的 HCC 患者 VWF:Ag/ADAMTS13:AC 比值和 VEGF 水平显著低于 PD 患者（均<0.05）。VWF:Ag/ADAMTS13:AC 比值高（>2.7）的患者 VEGF 水平高于比值低（≤2.7）的患者。多变量分析显示，VWF:Ag/ADAMTS13:AC 比值是 HAIC 治疗反应的预测因素。
VWF:Ag/ADAMTS13:AC 比值可能成为 HCC 患者在接受 HAIC 治疗前预测治疗反应的有用生物标志物。
