Assesment of serum alkaline phosphatase levels on the risk of presence hepatocelluler carcinoma in the liver transplantation patients

Aim: Multivarious serum biomarkers have been investigated for their potential prognostic value in HCC. This aim of study evaluatethe effects of Alkaline phosphatase levels on the risk of presence Hepathocelluler canser (HCC) among the liver transplantationpatients.Material and Methods: Between 2004 and 2018 878 consecutive adult Liver Tranplantation patients in our center was reviewedThese patients were divided into two groups according to presence of HCC [(n=208) HCC positive (Group A) and (n=670) HCCnegative (Group B)].Data collection included, We evaluated the predictive values of liver fonctions tested liver enzymes (alanineaminotransferase [ALT], aspartate aminotransferase [AST], alkaline phosphatase [ALP], and gamma-glutamyltransferase [GGT],Hemoglobine (Hb), international normalized ratio (INR). The independent sample t test, Mann Whitney U test, chi-square test andFisher exact test were used. to compare data. P-value of < 0.05 was considered statistically significant.Results: A total 878 patients included in this study. 670 patients had HCC negative (Group A ) 208 had HCC positive(Grup B). Themean age in each group were 57.06 ± 11.27 years in group A and 50.46 ± 13.7 years in group B. (p=0.032). HOMA IR [5.2 (0.6-36)in group A, 4.2 (0.2-85.0) in group B] were lower in group B( p= 0.001). Serum ALP levels [ 184.39 ± 159.72 U/L in Group A, 159.7 2±159.72 U/L in group B] were lower in group B (p = 0.046).Conclusion: Serum Alkaline phosphatase levels can be use as predictive component of the HCC. Follow-up studies are needed.

PDF

___

1. Torre LA, Bray F, Siegel R, et al. A. Global cancer statistics, 2012. Cancer J 2015;65:87-108.
2. Tanriverdi O. A discussion of serum albumin level in advanced-stage hepatocellular carcinoma: a medical oncologist’s perspective. Med Oncol 2014;31:282.
3. Zhu AX, Chen D, He W, et al. Integrative biomarker analyses indicate etiological variations in hepatocellular carcinoma. J Hepatol 2016;65:296-304.
4. Carr BI, Guerra V. Hepatocellular Carcinoma Extrahepatic Metastasis in Relation to Tumor Size and Alkaline Phosphatase Levels. Oncology 2016;90:136- 42.
5. El-Serag HB. Epidemiology of hepatocellular carcinoma. Clin Liver Dis 2001;5:87-107.
6. Pratt DS, Kaplan MM. Evaluation of abnormal liverenzyme results in asymptomatic patients. N Engl J Med 2000;342:1266-71.
7. Hann HW, Meyers RS, Hann RS, et al. Comprehensive Analysis of Common Serum Liver Enzymes as Prospective Predictors of Hepatocellular Carcinoma in HBV Patients. PLoS one 2012;7:47687
8. Strasak AM, Rapp K, Brant LJ, et al. Association of gamma- glutamyltransferase and risk of cancer incidence in men: a prospective study. Cancer Res 2008,68:3970-7.
9. Kumada T, Toyoda H, Kiriyama S, et al. Incidence of hepatocellular carcinoma in patients with chronic hepatitis B virus infection who have normal alanine aminotransferase values. J Med Virol 2010,82:539-45.
10. Liu X, Meng J, Xu H, et al. Alpha-fetoprotein to transaminase ratio is related to higher diagnostic efficacy for hepatocellular carcinoma. Medicine(Baltimore) 2019;98:15414.
11. Ren M, Juan Li JR. Liver function and energy metabolism in hepatocellular carcinoma developed in patients with hepatitis B-related cirrhosis. Medicine(Baltimore) 2019;98:15528.
12. Masuzaki R, Omata M. Screening program in high-risk populations. Hepatocellular Carcinoma 2011:55-68.
13. Wong RJ, Cheung R, Ahmed A. Nonalcoholic steatohepatitis is the most rapidly growing indication for liver transplantation in patients with hepatocellular carcinoma in the U.S. Hepatology 2014;59:2188-95.
14. L. Mobarak, D. Omran, M.M. Nabeel, et al. Fibro markers for prediction of hepatocellular carcinoma in Egyptian patients with chronic liver disease J Med Virol, 2017;89:1062-8.
15. Sahin T, Serin A, Emek E, et al. Effectiveness of Noninvasive Fibrosis Markers for the Prediction of Hepatocellular Carcinoma in Chronic Hepatitis B and Chronic Hepatitis B+D Induced Cirrhosis. Transplantation Proceeding September 2019;2397- 402.
16. Yu M Ch, Chan KM, Lee CF, et al. Alkaline Phosphatase: Does it have a Role in Predicting Hepatocellular Carcinoma Recurrence? J Gastrointestinal Surgery. 2011;15:1440-9.
17. Changchien CS, Chen CL, Yen YH, et al. Analysis of 6,381 hepatocellular carcinoma patients in southern Taiwan: prognostic features, treatment outcome, and survival. J. Gastroenterol 2008;43:159-70.
18. Yamamoto,K., T.Awogi, K.Okuyama, et al. Nuclear localization of alkaline phosphatase in cultured human cancer cells. Med. Electron Microsc 2003;36:47-51.
19. Rovesti G, Orsi G, Kalliopi A, et al Impact of Baseline Characteristics on the Overall Survival of HCC Patients Treated with Sorafenib: Ten Years of Experience. Gastrointest Tumors 2019;6:92-107.
20. WangQ, Chen Q, Zhang X, et al. Diagnostic value of gamma glutamyltransferase/aspartate aminotransferase ratio, protein induced by vitamin K absence or antagonist II, and alpha-fetoprotein in hepatitis B virus-related hepatocellular carcinoma. 2019;25:5515-29.
21. Park SJ, Jang JY, Jeong SW, et al. Usefulness of AFP, AFP-L3, and PIVKA-II, and their combinations in diagnosing hepatocellular carcinoma. Medicine (Baltimore) 2017;96:5811.
22. Johnson PJ, Berhane S, Kagebayashi C, et al. Assessment of liver function in patients with hepatocellular carcinoma: a new evidence-based approach-the ALBI grade. J Clin Oncol 2015;33:550-8.
23. Toyoda H, Lai PB, O’Beirne J, et al. Long-term impact of liver function on curative therapy for hepatocellular carcinoma: application of the ALBI grade. Br J Cancer 2016;114:744-50.
24. Frigaki M, Dimitra SP , Eleni O, et al Comparative evaluation of ALBI, MELD, and Child-Pugh scores in prognosis of cirrhosis: is ALBI the new alternative? Ann Gastrol 2019;32: 626-32.
25. Genng L, Zong R, Shi Y, et al. Prognostic role of preoperative albumin-bilirubin grade on patients with hepatocellular carcinoma after surgical resection: a systematic review and meta-analysis.Eur Gastroenterol Hepatol 2019.
26. Li Z, Guan M, Lin Y, et al. Aberrant Lipid Metabolism in hepatocellular Carcinoma Revealed by Liver Lipidomics. Int J Mol Sci 2017;18:2550.
27. Patterson A.D, Maurhofer O, Beyoglu D, et al. Aberrant Lipid Metabolism in Hepatocellular Carcinoma Revealed by Plasma Metabolomics and Lipid Profiling. Cancer Res2011;71:6590-600.
28. Zhang H, Gao C, Fang L, et al. Increased international normalized ratio level in hepatocellular carcinoma patients with diabetes mellitus World J Gastroenterol 2013;19:2395-403.
29. Dayer MR, Mard-Soltani M, Dayer MS, et al. Interpretation of correlations between coagulation factors FV, FVIII and vWF in normal and type 2 diabetes mellitus patients. Pak J Biol Sci 2011;14:552-7.
30. Finkelmeier F, Bettiger D, Köberle V, et al. Single measurement of hemoglobin predicts outcome of HCC patients. Medical Oncology 2014;31:806.