A Liver Index and its Relationship to Indices of HCC Aggressiveness

Carr, Brian I.; Guerra, Vito; Giannini, Edoardo G.; Farinati, Fabio; Ciccarese, Francesca; Rapaccini, Gian Ludovico; Marco, Maria Di; Benvegnù, Luisa; Zoli, Marco; Borzio, Franco; Caturelli, Eugenio; Masotto, Alberto; Trevisani, Franco

doi:10.4172/2329-6771.1000178

Cited by 38 publications

(41 citation statements)

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“…However, the decrease in cell growth was not associated with significant induction of apoptosis or autophagy. This represents another example of HCC biology in relation to microenvironmental liver factors [28] . Whether the albumin-mediated growth decrease is a result of an inhibitory action on AFP or a direct effect on the cell proliferation machinery/signaling has yet to be determined.…”

Section: Discussionmentioning

confidence: 97%

Role of Albumin in Growth Inhibition in Hepatocellular Carcinoma

et al. 2017

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Objective: Levels of serum albumin have recently emerged, together with C-reactive protein, as an important prognostic indicator for hepatocellular carcinoma (HCC). It has recently been reported that larger HCCs are associated with lower albumin levels. However, the albumin-mediated growth decrease has yet to be determined. Methods: We examined a large HCC cohort and then by direct exposure of HCC cells in vitro, the relationship of albumin levels to HCC growth. Results: We found that patients with lower albumin levels had significantly larger maximum tumor diameters, more portal vein thrombosis, more tumor multifocality, higher α-fetoprotein levels, and a lower survival than patients with higher albumin levels. Direct addition of exogenous albumin at physiological concentrations resulted in decreased growth in several HCC cell lines in vitro. We found a decrease in MAP kinase levels and in levels of Cdk2 and Cdk4, cyclinE, as well as in α-fetoprotein. Conclusion: These results indicate that in addition to its role as a monitor of systemic inflammation, albumin may have a direct role in HCC growth inhibition, either through modulation of α-fetoprotein or through its actions on growth-controlling kinases.

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Section: Discussionmentioning

confidence: 97%

Role of Albumin in Growth Inhibition in Hepatocellular Carcinoma

et al. 2017

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“…Additionally, albumin, as part of the ALBI grading system, has been shown to be a quantitative, useful and prognostic indicator of liver dysfunction in HCC patients (21)(22)(23)(24)(25). Albumin has previously been reported to have direct HCC growth inhibitory properties in vitro (26,27), and there is also suggestive clinical evidence for an inhibitory effect on HCC in patients (30)(31)(32). Several studies have also shown a decrease in albumin levels in human HCC cells compared with the non-HCC liver (33)(34)(35).…”

Section: Discussionmentioning

confidence: 99%

“…II) renders this explanation less likely. However, there is recent evidence suggesting an association between HCC growth and poorer liver function, except for albumin, which seems to be protective (27,(30)(31)(32). The mechanisms by which albumin might protect against HCC growth or damage are not yet clear, although there is some experimental evidence that albumin might directly suppress HCC growth (26,27), leading us to consider the possibility that in addition to its reflection of liver synthetic function and systemic inflammation, it might also have a direct tumor growth-modulating function in HCC patients.…”

Section: Discussionmentioning

confidence: 99%

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Serum Albumin Levels in Relation to Tumor Parameters in Hepatocellular Carcinoma Patients

Carr

Guerra

2017

Int J Biol Markers

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ORIGINAL RESEARCH ARTICLEFurthermore, albumin values have been used in the 2-parameter albumin-bilirubin (ALBI) quantitative grading system for liver function in HCC, which has in turn been incorporated into several staging systems (21-25). There is thus much recent interest in serum albumin levels in prognostication, mainly as a reflection of liver function in HCC. However, there is also some direct experimental evidence that increased albumin levels can actually suppress HCC cell growth (26,27). Viewed this way, albumin levels may influence prognosis as much by their actions on HCC biology as by their reflection of impaired liver function.In this study, we examined the clinical correlations of serum albumin levels in a large HCC patient cohort with parameters of HCC behavior, and found an inverse relationship between serum albumin levels and HCC aggressiveness. Methods Patient dataWe retrospectively analyzed a prospectively collected database of 4,139 HCC patients, as previously reported (28,29), who had full baseline tumor parameter data, including computed axial tomography (CT) scan information on HCC size, number of tumor nodules and presence of PVT and plasma AFP levels; complete blood counts; routine blood liver function tests (total bilirubin, γ-glutamyl transpeptidase [GGT] and albumin); and patient demographics. Database management conformed to legislation on privacy, and this study conformed to the ethical guidelines of the Declaration of Helsinki. Approval for this retrospective study

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“…Preliminary evidence has shown reduced HCC recurrence rates after resection and reduced death from all causes in HCC patients. [39][40][41][42][43][44] As the new therapies become incorporated into many aspects of HCC treatment, it is likely that they will enhance survival rates for HCC ablation, resection, and transplant.…”

Section: Effective New Antiviral Therapies: Are They Now Part Of Hepamentioning

confidence: 99%

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Marino

Carr²

2017

Exp Clin Transplant

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The use of orthotopic liver transplant for hepatocellular carcinoma was a major advance, pioneered by Thomas E. Starzl as a way to circumvent the limitations imposed on the liver surgeon by the presence of cirrhosis and liver failure. Patients with a few small tumors, whatever their degree of liver damage, may expect prolonged survival (70% at 5 years). Patients with more advanced tumors have high recurrence rates and more limited survival, possibly due to immune suppression or pretransplant understaging of their tumors. Another possibility is that patients with micrometastases have a longer survival time, during which the metastases eventually become evident. Recent advances include the identification of patients using levels of tumor markers to allow more careful patient selection with better outcomes. The con tributions of molecular signatures and the new, effective antiviral agents are possibly significant.

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A Liver Index and its Relationship to Indices of HCC Aggressiveness

Cited by 38 publications

References 31 publications

Role of Albumin in Growth Inhibition in Hepatocellular Carcinoma

Role of Albumin in Growth Inhibition in Hepatocellular Carcinoma

Serum Albumin Levels in Relation to Tumor Parameters in Hepatocellular Carcinoma Patients

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