Abstract: Objective To observe the efficacy of microwave ablation (MWA) in the treatment of primary liver cancer (PLC) and its effect on serum levels of Golgi protein 73 (GP73) and alpha fetoprotein (AFP).Methods A total of 102 PLC patients with a single small lesion (≤ 3 cm in diameter) and elevated AFP were retrospectively enrolled between January 2016 and October 2018. All of the PLC patients received MWA. Serum GP73, alpha-fetoprotein (AFP), and liver biochemical tests [serum albumin (Alb), total bilirubin (TBil), alanine aminotransferase (ALT), and aspartate aminotransferase (AST)] were compared before MWA and at different time points post the ablation procedure. The efficacy of MWA was evaluated by enhanced MRI or CT follow-up for more than 3 years.Results Complete tumor ablation was achieved in 97 patients (95.10%) with PLC at one month after MWA. The overall survival rates of 1, 2 and 3 years after MWA were 100.00%, 97.06% and 89.22%, respectively. In terms of PLC recurrence, cumulative recurrence occurred in 47 cases (46.08%) at 3 years after MWA, including 9 cases (8.82%) with local tumor progression and 38 cases (37.25%) with new tumors. The disease-free survival rates at 1, 2 and 3 years after MWA were 74.51%, 58.82% and 53.92%, respectively. The serum AFP levels significantly decreased at 1, 2, and 4 weeks after MWA, and returned to the normal range at 12 weeks after MWA. On the contrary, the serum GP73 level increased significantly at 1 and 2 weeks after MWA, and reached the peak at 2 weeks after MWA. After hepato-protective treatment, the serum GP73 declined at 4 weeks after MWA, and returned to the pre-treatment level at 12 weeks after MWA. Liver biochemical indicators of TBil, ALT, and AST were increased significantly at 1 week after MWA. Notably, the changes of serum GP73 in response to MWA were similar to those of liver biochemical indicators (TBil, ALT and AST).Conclusion Serum GP73 increased significantly after MWA treatment for PLC. Therefore, serum GP73 holds potential as a biomarker for monitoring and assessment of MWA-mediated inflammatory injury in patients with PLC. AFP can be used as a monitoring index to evaluate the treatment efficacy of MWA and HCC recurrence after MWA. The normalization of AFP is closely associated with a complete tumor ablation.

Key words: Primary liver cancer, Microwave ablation, Golgi protein 73, Alpha fetoprotein