Brian I Carr1, Harika Gozukara Bag2, Volkan Ince3,4, Sami Akbulut3,4, Veysel Ersan3,4, Sertac Usta3,4, Burak Isik3,4, Zeki Ogut4, Adem Tuncer4, Sezai Yilmaz3,4. 1. Liver Transplant Institute, Faculty of Medicine, Inonu University, Bulgurlu Mah, Elazig Yolu 15 km, 44280, Malatya, Turkey. brianicarr@hotmail.com. 2. Department of Biostatistics, Faculty of Medicine, Inonu University, 44280, Malatya, Turkey. 3. Liver Transplant Institute, Faculty of Medicine, Inonu University, Bulgurlu Mah, Elazig Yolu 15 km, 44280, Malatya, Turkey. 4. Department of Surgery, Faculty of Medicine, Inonu University, 44280, Malatya, Turkey.
Abstract
PURPOSE: HCC patients typically present at an advanced tumor stage, in which surgical therapies cannot be used. Screening ultrasound exams can increase the numbers of patients diagnosed with small tumors, but are often not used in patients at risk for HCC. We evaluated clinically available and cheap potential blood tests as biomarkers for screening patients at risk for HCC. METHODS: A comparison was made of commonly used blood count and liver function parameters in a group of patients (n = 101) with small HCCs (≤ 3 cm) or without HCC (n = 275), who presented for liver transplantation in our institute. RESULTS: Significant differences were found for blood lymphocytes and AST levels. This 2-parameter combination was found to be significantly different between patients with small HCCs versus no HCC. Using the combination of lymphocytes and AST levels to dichotomize the HCC patients, only blood levels of alpha-fetoprotein among the tumor characteristics were found to be significantly different among the 2 HCC groups, as well as levels of blood total bilirubin, ALKP, and PLR ratio. The results were confirmed using a separate smaller cohort of non-transplanted small size HCC patients. CONCLUSION: The combination of elevated blood levels of lymphocyte counts and AST levels holds promise for screening of patients with chronic liver disease who are at risk for HCC.
PURPOSE: HCC patients typically present at an advanced tumor stage, in which surgical therapies cannot be used. Screening ultrasound exams can increase the numbers of patients diagnosed with small tumors, but are often not used in patients at risk for HCC. We evaluated clinically available and cheap potential blood tests as biomarkers for screening patients at risk for HCC. METHODS: A comparison was made of commonly used blood count and liver function parameters in a group of patients (n = 101) with small HCCs (≤ 3 cm) or without HCC (n = 275), who presented for liver transplantation in our institute. RESULTS: Significant differences were found for blood lymphocytes and AST levels. This 2-parameter combination was found to be significantly different between patients with small HCCs versus no HCC. Using the combination of lymphocytes and AST levels to dichotomize the HCC patients, only blood levels of alpha-fetoprotein among the tumor characteristics were found to be significantly different among the 2 HCC groups, as well as levels of blood total bilirubin, ALKP, and PLR ratio. The results were confirmed using a separate smaller cohort of non-transplanted small size HCC patients. CONCLUSION: The combination of elevated blood levels of lymphocyte counts and AST levels holds promise for screening of patients with chronic liver disease who are at risk for HCC.
Authors: Jian Zheng; Ken Seier; Mithat Gonen; Vinod P Balachandran; T Peter Kingham; Michael I D'Angelica; Peter J Allen; William R Jarnagin; Ronald P DeMatteo Journal: Ann Surg Oncol Date: 2017-08-24 Impact factor: 5.344
Authors: Jessica A Davila; Robert O Morgan; Peter A Richardson; Xianglin L Du; Katherine A McGlynn; Hashem B El-Serag Journal: Hepatology Date: 2010-07 Impact factor: 17.425
Authors: Filippo Pelizzaro; Barbara Penzo; Giulia Peserico; Angela Imondi; Anna Sartori; Alessandro Vitale; Umberto Cillo; Edoardo G Giannini; Antonella Forgione; Gian Ludovico Rapaccini; Maria Di Marco; Eugenio Caturelli; Marco Zoli; Rodolfo Sacco; Giuseppe Cabibbo; Fabio Marra; Andrea Mega; Filomena Morisco; Antonio Gasbarrini; Gianluca Svegliati-Baroni; Francesco Giuseppe Foschi; Andrea Olivani; Alberto Masotto; Gerardo Nardone; Giovanni Raimondo; Francesco Azzaroli; Gianpaolo Vidili; Filippo Oliveri; Franco Trevisani; Fabio Farinati Journal: Liver Int Date: 2020-11-23 Impact factor: 5.828