Published online Aug 7, 2022. doi: 10.3748/wjg.v28.i29.3971
Peer-review started: February 21, 2022
First decision: April 16, 2022
Revised: April 30, 2022
Accepted: July 5, 2022
Article in press: July 5, 2022
Published online: August 7, 2022
Processing time: 163 Days and 4.8 Hours
Microwave ablation (MWA) is an effective treatment option for patients with primary liver cancer. However, it has been reported that the MWA procedure induces a hepatic inflammatory response and injury, which may negatively affect the efficacy of MWA. As such, the discovery of reliable markers to monitor the patient’s response to MWA is needed. Golgi protein 73 (GP73) has been shown to be associated with chronic liver disease. To date, the potential value of serum GP73 in the dynamic monitoring during MWA of liver cancer remains unclear.
To examine the effects of MWA on the serum levels of GP73 in patients with primary liver cancer.
A total of 150 primary liver cancer patients with a single small lesion (≤ 3 cm in diameter) were retrospectively enrolled spanning the period between January 2016 and October 2018. All of the patients received MWA for the treatment of primary liver cancer. Serum GP73, alpha-fetoprotein (AFP), and widely used liver biochemical indicators [serum albumin, total bilirubin (TBIL), alanine aminotransferase (ALT), and aspartate aminotransferase (AST)] were compared before MWA and at different time points, including 1, 2, and 4 wk following the ablation procedure.
Complete tumor ablation was achieved in 95.33% of the patients at 1 mo after MWA. The 1-, 2-, and 3-year disease-free survival rates were 74.67%, 59.33%, and 54.00%, respectively. The serum AFP levels were significantly decreased at 1, 2, and 4 wk after MWA; they returned to the normal range at 12 wk after MWA; and they remained stable thereafter during follow-up in those cases without recurrence. In contrast, the serum GP73 levels were significantly increased at 1 and 2 wk after MWA. The serum GP73 levels reached the peak at 2 wk after MWA, started to decline after hepatoprotective treatment with glycyrrhizin and reduced glutathione, and returned to the pretreatment levels at 12 and 24 wk after MWA. Notably, the changes of serum GP73 in response to MWA were similar to those of TBIL, ALT, and AST.
Serum GP73 is markedly increased in response to MWA of liver cancer. Thus, serum GP73 holds potential as a marker to monitor MWA-induced inflammatory liver injury in need of amelioration.
Core Tip: Microwave ablation (MWA) has become an effective modality of cancer treatment, including primary liver cancer. However, the MWA procedure induces a hepatic inflammatory response and injury, which may diminish the efficacy of MWA. Therefore, the discovery of reliable markers to monitor the response to MWA is still needed. In this study, we examined the effects of MWA on the serum levels of Golgi protein 73 (GP73). The resulting data suggest that serum GP73 is markedly elevated in response to the MWA procedure. Importantly, our novel findings may have the clinical implication that serum GP73 could be a potential marker to monitor MWA-induced inflammatory liver injury.