Prognostic Biomarker after Therapy for HCC

For hepatocellular carcinoma (HCC) patients, sCD163 may not be a reliable diagnostic marker but it can predict tumor response to locoregional therapies, according to a paper published in Egyptian Liver Journal.

Investigators from Cairo conducted a study of 40 adult patients in order to determine the role of sCD163 in patients with HCC in addition to hepatitis C-related liver cirrhosis. HCC typically stems from chronically inflamed liver tissues, and the majority of patients having hepatitis B, hepatitis C, cirrhosis, high alcohol consumption, obesity, genetic disorders, or contaminated foods.

Hemoglobin-haptoglobin scavenger receptor CD163 and its soluble form, sCD163, the study authors explained, is a promising biomarker of macrophage activation because it is shed from the cell surface into circulation. Eventually, macrophages could be a therapeutic target for HCC, as well.

The patients, all who had hepatitis C-related liver cirrhosis and HCC (called the HCC group), were randomly selected and then subjected to locoregional therapies, either transarterial chemoembolization (TACE) or radiofrequency ablation (RFA). An additional 20 patients with liver cirrhosis only were included in the analysis to serve as controls (LC group). All of the patients were also subject to routine lab tests and abdominal ultrasound.

The HCC patients had a mean age of 57 years, with 28 being male (70%). In the LC group, had a mean age of 54 years and 12 were male (60%).

The investigators measured alpha-fetoprotein (AFP) and sCD163 at baseline and after 1-month post-intervention. They learned that at baseline, sCD163 had a higher value in the HCC group though noted that it was insignificant. The median AFP value was much higher in the HCC group compared to the LC group.

After discovery of portal vein invasion in 4 HCC patients, they were excluded from logoregional therapy, but no patients in the LC group had PVT, the study authors said. sCD163 was significantly higher in cases with PVT, the study authors added, but AFP showed no difference in terms of PVT. This is aligned with previous studies, the investigators noted, but they also said they discovered a study that contradicted their association between sCD163 and vascular invasion.

Both sCD163 and AFP were statistically significant markers for estimating diagnostic efficacy, the study authors learned after analysis.

The investigators also compared sCD163 and AFP in both recurrent and eradicated HCC cases before and after intervention, they said. sCD163 showed a significant decrease in the eradicated cases and a significant increase in the recurrent cases. There was also a significant difference in pre-intervention mean sCD163 values between recurrent and eradicated HCC cases, the investigators added.

The study authors called age of patients, Child-Pugh score, s. albumin, and number and size of HCC focal lesions the most relevant demographic, clinical and biochemical data found in recurrent and eradicated HCC cases.

“It is concluded from this study that sCD163 has no reliable role as a diagnostic marker for HCC, yet it has a good prognostic role in predicting the tumor response to locoregional therapies as it showed a significant decline in eradicated cases of HCC after treatment,” the study authors concluded.