Comparison of ultrasound guided versus CT guided radiofrequency ablation on liver function, serum PIVKA-II, AFP levels and recurrence in patients with primary hepatocellular carcinoma

Zusheng Yu; Guowei Li; Nianyong Yuan; Wei Ding

Comparison of ultrasound guided versus CT guided radiofrequency ablation on liver function, serum PIVKA-II, AFP levels and recurrence in patients with primary hepatocellular carcinoma

Am J Transl Res. 2021 Jun 15;13(6):6881-6888. eCollection 2021.

Authors

Zusheng Yu¹, Guowei Li¹, Nianyong Yuan¹, Wei Ding¹

Affiliation

¹ Department of Hepatobiliary Surgery, The First People's Hospital of Fuyang Hangzhou Hangzhou 311400, Zhejiang, China.

PMID: 34306439
PMCID: PMC8290813

Abstract

Objective: This study aimed to compare the effects of ultrasound and CT-guided radiofrequency ablation (RFA) on liver function, serum antagonist-II (PIVKA-II), alpha-fetoprotein (AFP) levels, and disease recurrence in patients with primary hepatocellular carcinoma (PHC).

Methods: Ninety-eight patients with PHC were enrolled and treated with RFA. They were grouped as the ultrasound-guided group (n=51) and the CT-guided group (n=47) according to the specific guidance methods. The clinical efficacy, recurrence and survival after treatment, as well as the changes of liver function, serum PIVKA-II and AFP levels before and after treatment were compared between the two groups.

Results: The total effective rate of the CT-guided group (87.23%) was significantly higher than that of the ultrasound-guided group (62.75%) (P < 0.05). Total bilirubin (TBIL), direct bilirubin (DBIL), aspartate aminotransferase (AST), and alanine aminotransferase (ALT) were reduced in both groups after treatment (P < 0.05) and were lower in the CT-guided group than in the ultrasound-guided group (P < 0.05). Albumin (ALB) levels were elevated in both groups after treatment (P < 0.05) and were higher in the CT-guided group than in the ultrasound-guided group (P < 0.05). PIVKA-II and AFP levels decreased in both groups after treatment (P < 0.05) and were significantly lower in the CT-guided group than in the ultrasound-guided group (P < 0.05). The 2-year and 3-year recurrence rates in the CT-guided group were 4.26% and 8.51%, respectively, significantly lower than 17.65% and 27.45% in the ultrasound-guided group (P < 0.05), and the 2-year and 3-year survival rates in the CT-guided group were 89.36% and 72.34%, respectively, significantly higher than 72.55% and 50.98% in the ultrasound-guided group (P < 0.05).

Conclusion: Compared with ultrasound guidance, CT-guided RFA can more effectively improve liver function, reduce serum IVKA-II and AFP levels, reduce recurrence rate, and improve survival time in the treatment of PHC.

Keywords: CT-guided; PIVKA-II; Ultrasound-guided; liver function; methemoglobin; radiofrequency ablation; recurrence.