Plasma Adiponectin and Hepatocellular Carcinoma Survival Among Patients Without Liver Transplantation

Abstract

Aim To investigate the levels of leptin and adiponectin in prediction of hepatocellular carcinoma (HCC) survival among patients without liver transplantation. Materials and Methods We measured pretreatment plasma leptin and adiponectin in 172 HCC cases who were prospectively followed up over 7 years. Results Gender, hepatitis B virus (HBV) and hepatitis C virus (HCV) infection, high body mass index (BMI), diabetes mellitus (DM) history and Child-Pugh (CP) class were associated with leptin and adiponectin levels, while α-fetoprotein (AFP) and presence of metastasis, being outside the Milan criteria and Barcelona clinic liver cancer (BCLC) stage, were significantly associated with liver transplantation and HCC survival. No significant association was observed for leptin or adiponectin and HCC survival in the overall group. In subgroup analyses among those without liver transplantation, we found significant associations between metastasis, Milan criteria, BCLC stage, hepatitis B surface antigen (HBsAg) and HCC survival. When separately determining the Cox proportional hazard models and Kaplan-Meier survival curves by liver transplantation status, higher adiponectin was significantly associated with an increased hazard ratio (HR) of death of 1.72 (95% confidence interval (CI)=1.12–2.64), i.e. poor survival among patients without liver transplantation. A multivariate Cox proportional hazard model, including adiponectin, CP class, presence of metastasis, tumor outside of Milan criteria, AFP and BCLC stage B/C parameters, also showed significant association with poor HCC survival (likelihood ratio test p<0.0001). No significant impact was observed for leptin on HCC survival regardless of liver transplantation status. Conclusion Higher levels of plasma adiponectin may predict poor HCC survival among patients without liver transplantation.

The Possible Role of Adipokines in HCV Associated Hepatocellular Carcinoma

“…Meanwhile, no significant impact is present for serum adiponectine, leptin, visfatin or AFP on the OS of the patients. These results are in concordance with those of Shen et al, (2016), and in contrast with those of Sun et al, (2017) who reported that HCC patients with high serum visfatin levels had significantly shorter OS times compared to those with low serum visfatin levels. Many previous studies addressed the role of adipokines and obesity in the pathogenesis of NAFLD and HCC (Noureddin and Rinella, 2015;Perumpail et al, 2015), however none of these investigate their role in HCV chronic hepatitis and its progression to HCC.…”

Adipokines and Non-Alcoholic Fatty Liver Disease: Multiple Interactions

“…Patients with increased serum levels of adiponectin had an increased risk for HCC development in subsequent disease course [ 64 ]. Higher plasma levels of adiponectin could predict poor HCC survival among patients without liver transplantation [ 65 , 66 ]. Higher levels of non-HMW adiponectin also conferred an increased risk for later development of HCC in a large prospective study [ 67 ].…”

“…Whereas levels of non-HMW adiponectin evolved as an attractive biomarker in predicting later development of HCC in a large prospective study, results for serum leptin were negative [ 67 ]. In addition, in the other aforementioned study in which adiponectin strongly correlated with stage of liver disease, presence of metastasis, α-fetoprotein (AFP) and Barcelona clinic liver cancer (BCLC) stage B/C and survival, no significant impact was observed for leptin on HCC survival [ 65 ]. Adiponectin treatment suppresses leptin-induced cell proliferation of HCC cells and adiponectin treatment impairs leptin-induced invasion of HCC cells [ 71 ].…”

Survival Following Palliative External-beam Radiotherapy of Locally Advanced and Metastatic Liver Cancer

“…The number of patients with liver cancer is constantly increasing and, therefore, these patients are increasingly becoming the focus of anticancer research (7)(8)(9)(10)(11). Most patients presenting with locally or systemically advanced primary liver cancer have a poor prognosis, particularly patients with metastatic disease (3)(4)(5).…”