Elevated urinary transforming growth factor-beta1 level as a tumour marker and predictor of poor survival in cirrhotic hepatocellular carcinoma.
To assess the clinical relevance of transforming growth factor-beta1 (TGF-beta1) in hepatocellular carcinoma (HCC), urinary TGF-beta1 and serum alpha-fetoprotein (AFP) were determined in 94 patients with cirrhotic HCC, 94 age- and sex-matched patients with cirrhosis alone and 50 healthy adults. TGF-beta1 level in HCC was higher than in cirrhosis alone or in healthy controls (each P = 0.0001). There is an inverse correlation between TGF-beta1 and AFP levels (r = -0.292, P = 0.004). Significantly higher TGF-beta1 level was found in HCC patients with worsening Child-Pugh stages, diffuse HCC, tumour size > 3 cm, multilobular tumour and AFP < or = 20 ng ml(-1). TGF-beta1 level decreased after complete treatment with transcatheter arterial chemoembolization (P = 0.0001). The median survival in HCC patients with raised TGF-beta1 was shorter than those with normal TGF-beta1 (P = 0.018). Multivariate analysis indicated that TGF-beta1 and AFP were significantly correlated with the presence of HCC. In addition, TGF-beta1 could be used as a diagnostic marker for HCC, particularly in tumours with low AFP production. In conclusion, elevated urinary TGF-beta1 level is a tumour marker and predictor of poor survival for cirrhotic HCC.
Tsai
J F
JF
Department of Internal Medicine, Kaohsiung Medical College, Taiwan, Republic of China.
Jeng
J E
JE
Chuang
L Y
LY
Yang
M L
ML
Ho
M S
MS
Chang
W Y
WY
Hsieh
M Y
MY
Lin
Z Y
ZY
Tsai
J H
JH
D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000652:urine*; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology / Q000652:urine*; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000401:mortality / Q000473:pathology / Q000652:urine*; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000652:urine*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011863:Radioimmunoassay; D015996:Survival Rate; D016212:Transforming Growth Factor beta / Q000652:urine*; D000509:alpha-Fetoproteins / Q000378:metabolism
D014408:Biomarkers, Tumor; D016212:Transforming Growth Factor beta; D000509:alpha-Fetoproteins