Evaluation of Parathyroid hormone serum level in HCV-related hepatocellular carcinoma.

Abstract

Background:The role displayed by parathyroid hormone (PTH) in HCV-related hepatocellular carcinoma (HCC) is not clearly defined. Aim: To investigate serum levels of parathyroid hormone, ionized Calcium (Ca) and corrected calcium in HCV-induced cirrhosis with HCC and to assess if their levels have relation to the child score and MELD score of HCC. Patients and methods: This study recruited patients with HCV-related HCC and HCV infected patients without HCC. A group of healthy subjects was also studied as controls. Liver and renal biochemical profiles, complete blood count and INR were determined. The serum levels of intact PTH (iPTH), ionized calcium and corrected calcium were measured in the three groups. Results: This cross-sectional observational study included fifty cirrhotic patients with HCV-related HCC, 70 HCV infected chronic liver disease patients without HCC and 30 healthy controls. iPTH serum level was significantly higher in the HCC patients compared to the other HCV infected chronic liver disease patients and to the healthy controls, (p<0.001). In addition, ionized calcium and corrected calcium serum levels were significantly raised in HCC than in HCV infected chronic liver disease patients without HCC, (p<0.001). There was no significant difference in iPTH levels between child B and child C HCC patients. Multiple regression analysis indicated the both iPTH and ionized calcium levels were independent predictors for HCC in HCV infected patients, (OR for PTH was 1.01; 95%CI: 1.004-1.02 with p= 0.002. and OR for corrected calcium was 3.18; 95%CI: 1.96-5.14 with p= <0.001). Conclusion: This study indicated the prevalent high levels of iPTH in HCC and associated hypercalcemia and this was not related to liver function. iPTH can be considered as a predictor for HCC occurrence in HCV infected chronic liver disease patients.