Circulating cell-free mtDNA content is associated with outcome of HCC patients receiving TACE combined with traditional Chinese medicine treatment

Abstract Objectives: Hepatocellular carcinoma (HCC) accounts for 70%-85% of liver cancer, and about 85% of HCC are hepatitis B virus-related hepatocellular carcinoma (HBV-HCC) in china. Most patients are already in the middle or late stages of the disease at the time of diagnosis, trans-hepatic arterial chemoembolization (TACE) combine with traditional Chinese medicine (TCM) have been reported as an effective treatment, and effective prognostic molecular markers are helpful to predict therapeutic efficacy. In this study, we aim to explore whether circulating cell-free mitochondrial DNA (ccf-mtDNA) content is associated with the outcome for HCC patients receiving TACE combine with TCM treatment. Method: Retrospective analysis was conducted in a cohort with 141 HBV-HCC patients. Univariate and multivariate analysis was conducted with Cox proportional risk regression model to explore the correlation between ccf-mtDNA content and patient prognosis. Kaplan-Meier method was used to draw the survival curve of ccf-mtDNA content and the survival prognosis of patients. Results: (1) high content of serum ccf-mtDNA is an independent risk factor for the prognosis of HBV-HCC patients treated with TACE combined with TCM adjuvant therapy (HR=4.010, 95%IC=1.252-12.844, P = 0.019). (2) K-M survival analysis showed that patients with high ccf-mtDNA content had poor prognosis (Log Rank P=0.027). Conclusions: Our findings suggest that ccf-mtDNA is a potential novel non-invasive biomarker for prognosis of HCC patients receiving TACE combine with TCM treatment.