Prognostic value of the combination of serum levels of vascular endothelial growth factor, C-reactive protein and contrast-enhanced ultrasound in patients with primary liver cancer who underwent transcatheter arterial chemoembolization

Abstract

Background: This study aimed to evaluate the prognostic value of the combination of serum levels of vascular endothelial growth factor (VEGF), C-reactive protein (CRP), and contrast-enhanced ultrasound (CEUS) in patients with primary liver cancer (PLC) after transcatheter arterial chemoembolization (TACE).

Methods: Overall, 287 PLC patients who had undergone TACE were allocated into recurrence and non-recurrence groups. One day before and seven days after TACE, CEUS was performed, and serum VEGF and CRP levels were determined. All patients were assigned into either a short time-to-radiologic progression (TTRP) group (TTRP ≤ 12 months) or a long TTRP group (TTRP > 12 months).

Results: Serum VEGF and CRP levels were higher in the recurrence group than the non-recurrence group after TACE. The sensitivity and specificity of CEUS parameters, serum VEGF and CRP levels, and the three combined, were utilized for the purposes of predicting the postoperative recurrences of PLC, which were 80.9% and 87.8%, 81.7% and 71.5%, 67.0% and 69.8%, and 87.8% and 90.1%, respectively.

Conclusion: This study demonstrated that high serum levels of both VEGF and CRP in addition to a low time-to-peak (TTP) value in CEUS were indicators for poor prognosis in PLC patients.

Keywords: C-reactive protein; Primary liver cancer; contrast-enhanced ultrasound; prognosis; transcatheter arterial chemoembolization; vascular endothelial growth factor.