RESUMEN
OBJECTIVE: To explore the predictive value of preoperative enhanced CT combined with des-γ-carboxy-prothrombin(DCP) level for microvascular invasion(MVI) of hepatocellular carcinoma(HCC).METHODS: The clinicaldata of 105 cases of HCC diagnosed by pathology after surgical resection from January 1,2016 to March 1,2019 in thethe Affiliated Hospital of Southwest Medical University were analyzed retrospectively. According to the pathologicalresults,they were divided into two groups: experimental group(with MVI): 30 cases,control group(without MVI): 75 cases,using univariate and multivariate logistic regression analysis to predict influencing factors of MVI in HCC. Thereceiver working curve(ROC curve)was used to evaluate the predictive value of DCP combined with enhanced CT forMVI in HCC.RESULTS: Univariate analysis showed that serum DCP level(t=4.667,P<0.001),tumor size(t=9.427,P<0.001),capsule type(χ~2=18.456,P<0.001) and pathological type(χ~2=11.914,P=0.003) were risk factors for MVI in HCC,with statistically significant differences(P<0.05). Multivariate logistic regression analysis showed that tumor size(OR=12.610,P=0.001),capsule type(OR=14.363,P=0.008) and serum DCP level(OR=19.254,P=0.014)were independentrisk factors of MVI in HCC,with statistically significant differences(P<0.05). ROC curve analysis showed that thesensitivity,specificity and area under the curve(AUC) of serum DCP and enhanced CT model for predicting MVI in HCCwere 90.0%,74.7% and 0.856,respectively.CONCLUSION: Preoperative serum DCP level combined with enhanced CThelps predict MVI in HCC.
RESUMEN
Des-γ-carboxy prothrombin (DCP)is produced abnormally in hepatocellular carcinoma cells. Vitamin K utilizing deficiency and the decreasing activity of vitamin K-dependent γ-glutamyl carboxylate and coenzyme may involve in production of DCP. The enzymes in bepatocellular carcinoma cells are failed in carboxylating all the ten glutamic acid residues in amino- terminus of prothrombin precursor to Gla and make the difference between DCP and prothrombin. DCP is considered to be the marker for diagnosis of hepatocellular carcinoma. DCP might also be one of the growth-promoting factors to carcinoma cells. Therefore, inhibition of DCP in hepatocellular carcinoma cells is considered to be the therapeutic method of blocking hepatocellular car-cinoma growth. Vitamin K and its analogs are found to have the functions of inhibiting hepatocellular carcinoma cell producing DCP. The mechanism may relate to the increase of γ-glutamyl carboxylase activity.
RESUMEN
No abstract available.