Predicting the risk of portal vein thrombosis in patients with liver cirrhosis and hepatocellular carcinoma

Abstract

The mechanisms of the hypercoagulable state in cirrhotics with and without hepatocellular carcinoma are incompetently comprehended. Objective: We aimed to explore the plasma Annexin A5/PS + MP ratio in these patients. Higher levels of Annexin A5 and PhosphatidylSerine bearing microparticles have been observed in cases of inflammation and increased coagulation but there are no studies which explore if there is an association between them and PVT in cirrhotics with and without HCC. So, our goal is to estimate their role in predicting PVT within HCV cirrhotics with and without HCC. 91 HCV cirrhotics with and without HCC and 20 healthy people (controls) were enlisted. Cirrhotics with and without HCC who developed PVT displayed higher levels of PS + MPs and lower Annexin A5/PS + MPs ratio (38.73 ± 1.92) and (0.00238 ± 0.00047) than cirrhotics who didn't develop PVT (22.19 ± 10.58) and (0.00451 ± 0.0023) (P < 0.001). Among the tested factors, lower Annexin A5/PS + MPs ratio show higher performance in predicting PVT in total cirrhotics, AUC, 0.919 followed by PS + MPs level, 0.876, Portal flow velocity, 0.842, Plasma Annexin A5 level, 0.509. In our hypothesis, As phosphatidylserine exposure increase due to increased level of circulating microparticles in cirrhotics with and without HCC, anenxin-A5 may be secreted by platelets and endothelial cells into the circulation as a physiological response to inactivate the elevated levels of PS bearing MPs produced in these patients but the increase in anenxin-A5 level isn't equivalent to the increase in PS bearing MPs levels. The equilibrium between plasma annexin A5 and PS bearing MPs levels is defected.

Genetic Analysis of Platelet-Related Genes in Hepatocellular Carcinoma Reveals a Novel Prognostic Signature and Determines PRKCD as the Potential Molecular Bridge

“…In summary, these results preliminarily proved that our risk gene PRKCD could either participate in the modulation of malignant biological behaviors of cancer cells as well as regulate the activation of platelets in vitro, implicating that PRKCD might act as a key molecular bridge in the cross-talk between HCC cells and platelets and also take an essential part in the platelet-induced HCC progression. Meanwhile, to explore whether platelet stimulation can mediate HCC progression by regulating the expression levels of other risk genes, based on the previous literature reports [ 22 , 23 ], we selected another two risk genes (ANXA5 and CFL1) that might be related to platelets for subsequent in vitro functional verification. And based on previous studies of these two genes in HCC [ 24 , 25 ], we synthesized two siRNA sequences respectively to knockdown the expression level of ANXA5 and CFL1 to investigate their potential function.…”

Development of a risk score to predict portal vein tumor thrombosis in patients with hepatocellular carcinoma

“…Akkiz et al reported that three factors, tumor diameter >5.0 cm, tumor multifocality, and elevated alpha-fetoprotein, could be used together to predict the presence of PVTT with an OR of 17.9 [36]. In a study of 47 cirrhotic patients with hepatocellular carcinoma, Serag et al reported that Annexin A5 and phosphatidylserine-bearing microparticles may be predictive of PVTT [37]. Herein, multivariate analysis found eight factors that were used to construct our score.…”

“…In a study of 47 cirrhotic patients with hepatocellular carcinoma, Serag et al . reported that Annexin A5 and phosphatidylserine-bearing microparticles may be predictive of PVTT [ 37 ]. Herein, multivariate analysis found eight factors that were used to construct our score.…”

An Integrated Bioinformatics Analysis towards the Identification of Diagnostic, Prognostic, and Predictive Key Biomarkers for Urinary Bladder Cancer

“…As regards blood plasma specimens, 11 genes, namely ANXA5 , ASPM , CD34 , CDC20 , CDT1 , COL4A5 , COL6A1 , ECT2 , HJURP , MCM2 , and VEGFA , presented with statistically significant differential expression between BCa and healthy individuals. In previous findings, Annexin A5 ( ANXA5 ) plasma levels were investigated as a potential biomarker for asthma diagnosis [ 109 ], pregnant and non-pregnant subjects [ 110 ], as well as for liver cirrhosis and hepatocellular carcinoma [ 111 ]. Abnormal spindle protein homolog ( ASPM ) was detected in circulating tumor cells through single-cell genomic characterization in cancer patients [ 112 ].…”