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Prognostic value of serum HIF-1α change following transarterial chemoembolization in hepatocellular carcinoma

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Abstract

Transarterial chemoembolization (TACE) induces a change in serum HIF-1α level in patients with hepatocellular carcinoma (HCC). This study investigated the prognostic value of change in serum HIF-1α following TACE treatment in HCC patients. A total of 61 hepatocellular carcinoma patients treated with TACE were included. Peripheral blood samples were collected within 1 week before and after TACE to determine the serum levels of hypoxia-inducible factor-1α (HIF-1α) and vascular endothelial growth factor-A (VEGF-A) by enzyme-linked immunosorbent assay (ELISA). Serum HIF-1α change was calculated as follows: ∆HIF-1α = (HIF-1α (pre-TACE) − HIF-1α (post-TACE))/HIF-1α (pre-TACE). Likewise, serum VEG-F change was calculated as follows: ∆VEG-F = (VEG-F (pre-TACE) − VEG-F(post-TACE))/VEG-F (pre-TACE). Based on the cutoffs (0.25) determined by the maximum Youden’s index in receiver operating characteristic analysis, the patients were grouped into the low ∆HIF-1α group (< 0.25) and the high ∆HIF-1α group (> 0.25). After TACE treatment, HIF-1α was significantly decreased (pre-TACE 1901.62 vs. post-TACE 621.82 pg/ml, P < 0.01) but VEGF-A was significantly increased (pre-TACE 60.80 vs. post-TACE 143.81 pg/ml, P < 0.01). Multivariate logistic regression analysis demonstrated that ∆HIF-1α was a prognostic factor (OR = 58.09, 95% CI: 1.59–2127.32, P = 0.027) for the TACE treatment response. Furthermore, multivariate Cox regression analysis revealed that ∆HIF-1α was a prognostic factor for progression-free survival (PFS) (HR = 0.30, 95% CI: 0.14–0.66, P = 0.003) and overall survival (OS) (estimated HR = 0.38, 95% CI: 0.16–0.93, P = 0.034). Kaplan–Meier survival analysis showed that the high ∆HIF-1α group was more likely to have longer PFS (log-rank test, P = 0.004) and OS (log-rank test, P = 0.002) than the low ∆HIF-1α group. The change in serum HIF-1α level following TACE is a prognostic factor associated with the TACE treatment response, PFS, and OS in HCC patients following TACE.

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Funding

This study was supported by the National Natural Science Foundation of China [81172193].

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Author notes

  1. Zhi-Huan Lin, Jun-Rong Jiang and Xiao-Kun Ma have contributed equally to this work.

Authors and Affiliations

  1. Department of Medical Oncology, The Third Affiliated Hospital, Sun Yat-Sen University, 600 Tianhe Road, Guangzhou, 510630, China

    Zhi-Huan Lin, Jun-Rong Jiang, Xiao-Kun Ma, Jie Chen, Xing Li, Xiang-Yuan Wu & Qu Lin

  2. Department of Medical Oncology, The Eastern Hospital of the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510630, China

    Zhi-Huan Lin & He-Ping Li

  3. Department of Interventional Radiology, The Third Affiliated Hospital, Sun Yat-sen University, 600 Tianhe Road, Guangzhou, 510630, China

    Ming-Sheng Huang

  4. Guangdong Key Laboratory of Liver Disease Research, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, China

    Ming-Sheng Huang & Qu Lin

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  1. Zhi-Huan Lin
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Lin, ZH., Jiang, JR., Ma, XK. et al. Prognostic value of serum HIF-1α change following transarterial chemoembolization in hepatocellular carcinoma. Clin Exp Med 21, 109–120 (2021). https://doi.org/10.1007/s10238-020-00667-8

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  • DOI: https://doi.org/10.1007/s10238-020-00667-8

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