Serum glypican-3 for the prediction of survival in patients with hepatocellular carcinoma

肝细胞癌 医学 内科学 危险系数 胃肠病学 腹水 比例危险模型 肝硬化 置信区间 肝癌 肿瘤科
作者
Aurora Nicolosi,Silvia Gaia,Alessandra Risso,Chiara Rosso,Emanuela Rolle,Maria Lorena Abate,Antonella Olivero,Angelo Armandi,Davide Giuseppe Ribaldone,P. Carucci,Sharmila Fagoonee,Rinaldo Pellicano,Giorgio Maria Saracco,Elisabetta Bugianesi,Gian Paolo Caviglia
出处
期刊:Minerva gastroenterology [Edizioni Minerva Medica]
卷期号:68 (4) 被引量:4
标识
DOI:10.23736/s2724-5985.21.03006-0
摘要

Glypican-3 (GPC-3) is a heparan sulfate proteoglycan overexpressed by hepatocellular carcinoma (HCC) cells. Several studies highlighted the diagnostic and prognostic value of GPC-3 expression in liver tissue, while data on the reliability of serum GPC-3 are limited and conflicting. We aimed to evaluate the prognostic value of serum GPC-3 in patients with HCC.A total of 449 patients (91 F and 358 M; median age 65 [38-86] years) with a new diagnosis of HCC and available serum samples collected at tumor diagnosis were retrospectively analyzed. All patients had cirrhosis and the main underlying etiology was viral (N.=323, 72%). Barcelona Clinic Liver Cancer (BCLC) staging system was adopted for patients' classification (BCLC 0/A, N.=293, 65% vs. B/C/D, N.=156, 35%) and treatment allocation. Response to therapy was assessed by modified Response Evaluation Criteria in Solid Tumors (mRECIST).Median overall survival (OS) after HCC diagnosis was 30 months (95% confidence interval [CI]: 27-34). Patients with serum GPC-3>150 pg/mL showed lower overall survival (16; 95%CI: 13-24 months) compared to those with GPC-3≤150 pg/mL (36; 95%CI: 30-56 months) (Log-rank test, P<0.001). At multivariate Cox proportional-hazard regression analysis, presence of ascites (adjusted Hazard Ratio [aHR]=1.84; 95%CI: 1.23-2.74, P=0.003), BCLC stage (aHR=1.65; 95%CI: 1.39-1.97, P<0.001), mRECIST (aHR=0.33; 95%CI: 0.21-0.51, P<0.001) and GPC-3>150 pg/mL (aHR=2.02; 95%CI: 1.47-2.78, P<0.001) resulted significantly associated to overall survival.Serum GPC-3 resulted an independent prognostic factor for patients with HCC irrespectively from tumor stage and response to therapy.
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