Quantitative analysis of plasma HBV DNA for early evaluation of the response to transcatheter arterial embolization for HBV-related hepatocellular carcinoma.

AIM: Transcatheter arterial embolization (TAE) is an important palliative treatment for patients with hepatocellular carcinoma (HCC) who are poor candidates for surgery or percutaneous ablative therapy. It generally takes 4 wk after lipiodol-TAE to properly assess lipiodol retention on computed tomography (CT). HBV DNA is integrated into the genome of HCC cells, and circulating plasma DNA may serve as a marker for cell damage. We assessed changes in plasma HBV DNA after TAE in HBV-related HCC and correlated the levels with the pattern of lipiodol accumulation on CT.
METHODS: Between April and June 2001, 14 patients with HBV-associated HCC who underwent TAE for inoperable or recurrent tumor were studied. Levels of plasma HBV DNA were measured by real-time quantitative PCR daily for five consecutive days after TAE. More than twofold elevation of circulating HBV DNA was considered as a definite elevation. Abdominal CT was performed 1-2 mo after TAE for the measurement of lipiodol retention.
RESULTS: Circulating HBV DNA in 10 out of 13 patients was elevated after TAE, except for one patient whose plasma HBV DNA was undetectable before and after TAE. In group I patients (n = 6), the HBV DNA elevation persisted for more than 2 d, while in group II (n = 7), the HBV DNA elevation only appeared for 1 d or did not reach a definite elevation. There were no significant differences in age or tumor size between the two groups. Patients in group I had significantly better lipiodol retention (79.31+/-28.79%) on subsequent abdominal CT than group II (18.43+/-10.61%) (P = 0.02).
CONCLUSION: Patients with durable HBV DNA elevation for more than 2 d correlated with good lipiodol retention measured 1 mo later, while others associated with poor lipiodol retention. Thus, circulating HBV DNA may be an early indicator of the success or failure of TAE.