Pre-TACE CK-MB/CK Ratio as an Independent Prognostic Biomarker in Advanced Hepatocellular Carcinoma
Weiguo Lu1, Ying Lu2, Yang Wang1
1Department of Clinical Laboratory, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, People's Republic of China.
Purpose:
Primary liver cancer is a prevalent malignancy with a poor prognosis globally. Patients with advanced disease often undergo transarterial chemoembolization (TACE), yet simple and effective prognostic biomarkers are lacking. This study aimed to investigate the prognostic value of the serum creatine kinase isoenzyme MB to total creatine kinase (CK-MB/CK) ratio in patients with advanced primary liver cancer receiving TACE.
Patients And Methods:
A single-center retrospective cohort study was conducted, enrolling 158 patients between January 2021 and September 2024. Based on a CK-MB/CK ratio cutoff of 1, patients were categorized into an abnormal group (n=52) and a normal group (n=106). Comparative analysis of baseline characteristics, Kaplan-Meier survival analysis, and Cox proportional hazards regression modeling were performed to assess the relationship between the CK-MB/CK ratio and overall survival (OS).
Results:
Patients in the abnormal group exhibited lower body mass index (BMI), lower rates of previous hepatectomy, higher levels of tumor markers (including AFP and CEA), and poorer liver function indices compared to the normal group. Kaplan-Meier analysis revealed a significantly shorter OS in the abnormal group (median OS: 15.0 months vs 32.5 months, log-rank P < 0.001). Multivariate Cox regression analysis confirmed that an elevated CK-MB/CK ratio was an independent risk factor for OS, with a hazard ratio of 3.895 (95% confidence interval: 1.946-7.79).
Conclusion:
This retrospective single-center study suggests that a CK-MB/CK ratio >1 may serve as an independent and easily accessible marker of poor prognosis in patients with advanced liver cancer undergoing TACE. Further validation in larger cohorts is needed. This marker is cost-effective and readily available in routine clinical practice, showing potential for risk stratification. When combined with D-dimer, it may provide a practical tool for clinical prognostic stratification.