May plasma cholesterol level be considered a neoplastic marker in liver disease from cirrhosis to hepatocellular carcinoma?
BACKGROUND
Although the role of cholesterol in tumourigenesis is unclear, it is used by the tumoural cells for biosynthetic processes and for steroid synthesis.


OBJECTIVE
To accertain whether plasma cholesterol levels might be a reliable neoplastic marker of a developing hepatocellular carcinoma in patients with liver cirrhosis.


METHODS
Plasma cholesterol has been studied in 287 liver cirrhosis patients without hepatocellular carcinoma and in 132 patients with hepatocellular carcinoma.


RESULTS
Cholesterol (mean +/- SEM) was higher in hepatocellular carcinoma patients when compared with age-, sex- and Child-Pugh class matched cirrhotic controls. In Child-Pugh class A, B and C with uncomplicated liver cirrhosis these values were, respectively, 142.0 +/- 2.5, 117.3 +/- 2.5, 97.4 +/- 2.9 vs 172.5 +/- 4.7, 163.8 +/- 7.9, 153.5 +/- 8.0 +/- mg/dl in patients with hepatocellular carcinoma (p < 0.001). A significant increase of cholesterol (p < 0.001) has been reported in the patients with liver cirrhosis when complicated by hepatocellular carcinoma and it was not related to cholestasis.


CONCLUSIONS
This observation seems to suggest that the enhanced cholesterol biosynthesis by tumoural cells leads to a rise in plasma cholesterol of patients with cancer, and, moreover, that, this increase may be used as a neoplastic marker indicating the development of a tumour in patients with liver cirrhosis.
Venturini
I
I
Department of Internal Medicine, University of Modena, Italy.
Amedei
R
R
Modonesi
G
G
Cosenza
R
R
Miglioli
L
L
Cioni
G
G
Zeneroli
M L
ML
D014408:Biomarkers, Tumor / Q000097:blood*; D001706:Biopsy; D006528:Carcinoma, Hepatocellular / Q000097:blood* / Q000209:etiology / Q000473:pathology; D002784:Cholesterol / Q000097:blood*; D003124:Colorimetry; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood* / Q000150:complications / Q000473:pathology; D008113:Liver Neoplasms / Q000097:blood* / Q000209:etiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012372:ROC Curve; D012307:Risk Factors
D014408:Biomarkers, Tumor; D002784:Cholesterol