Published online Dec 7, 2020. doi: 10.3748/wjg.v26.i45.7232
Peer-review started: August 4, 2020
First decision: September 30, 2020
Revised: October 9, 2020
Accepted: November 13, 2020
Article in press: November 13, 2020
Published online: December 7, 2020
Processing time: 122 Days and 0.2 Hours
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 via 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 via 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) (P < 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 P < 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.
Core Tip: The prediction of HAIC treatment response is needed to improve the prognosis in patients with hepatocellular carcinoma (HCC). Von Willebrand factor antigen (VWF:Ag)/ADAMTS13 activity (ADAMTS13:AC) ratio was significantly lower in HCC patients with stable disease + partial response than those with progressive disease. VWF:Ag/ADAMTS13:AC ratio become a useful biomarker to predict HAIC treatment response.
