A high value of serum des-γ-carboxy prothrombin before hepatocellular carcinoma treatment can be associated with long-term liver dysfunction after treatment

Background Transcatheter arterial chemoembolization (TACE) is an effective treatment for hepatocellular carcinoma (HCC), but it sometimes makes liver function worse. The pre-TACE prediction of liver dysfunction after TACE would be helpful to avoid long-term liver dysfunction. Methods We performed a case–control study in 100 HCC patients who underwent TACE at Kobe University Hospital. Urinary/blood biochemical examinations were performed before TACE. As an indicator of liver function, Child’s score was also evaluated before and 3 months after TACE. Cases with and without an increase of 2 points or more in the Child’s score were compared, and independent risk factors were statistically examined. A pre-TACE predictive model of an increase of 2 points or more in the Child’s score after TACE was developed using logistic regression. Results Univariate analyses showed that des-γ-carboxy prothrombin (DCP) and lactate dehydrogenase (LDH) before TACE were significantly higher in the Child’s score-deteriorated group than in the group with no deterioration ( p = 0.036 and 0.003, respectively). All possible multivariate regressions showed that DCP ( p = 0.003) and LDH ( p = 0.002) were independent factors determining the deterioration of Child’s class. A predictive model was developed, as follows: exp(0.014 × LDH + 0.572 × ln(DCP) − 8.655)/(1 + exp(0.014 × LDH + 0.572 × ln(DCP) − 8.655)). The model discriminated well, with AUC being 0.837 (95 % confidence interval [CI] 0.662–1.000). The optimal cut-off point was 0.073, and the sensitivity and specificity were 90.9 and 69.7 %, respectively. Conclusions High values of DCP and LDH before TACE were associated with the long-term deterioration of liver function. Our pre-therapeutic prediction model could be useful to identify high-risk cases.