Evaluation of circulating activin-A as a serum marker of hepatocellular carcinoma.
Because in experimental hepatocarcinogenesis apoptosis increases from normal to preneoplastic to carcinoma tissue, proapoptotic factors, such as activin-A, may represent useful markers for hepatocellular carcinoma (HCC). In this study, serum activin-A was measured in 99 cirrhotic patients, of whom 55 had HCC. Activin-A concentrations were higher in HCC patients (median, 2.33 ng/ml; range, 0.41-8.12) than in patients with nonmalignant cirrhosis (1.28 ng/ml; range, 0.35-6.25) (P < .05). All 12 patients with activin-A greater than 3 ng/ml and serum alpha-fetoprotein greater than 30 ng/ml had HCC, in comparison to 32 of 41 patients who had only one and to 11 of 46 patients who had both markers below these cutoffs (P < .0001). No correlation was found between activin-A and alpha-fetoprotein in the two groups, whereas in patients with HCC, activin-A was strictly correlated with serum aspartate aminotransferase (P < .001). Activin-A mRNA for inhibin betaA subunit was expressed both in tumor and nontumor liver tissues in a case of HCC superimposed on cirrhosis and was not expressed in a case of HCC without cirrhosis. In conclusion, cirrhotic patients with HCC have high serum activin-A, to the production of which both the cirrhotic liver and the liver tumor are likely to contribute.
DPMSC, Cattedra di Ostetricia e Ginecologia, University of Udine, Italy.
M
M
Pirisi
C
C
Fabris
S
S
Luisi
M
M
Santuz
P
P
Toniutto
D
D
Vitulli
E
E
Federico
M
M
Del Forno
M
M
Mattiuzzo
B
B
Branca
F
F
Petraglia
D028341:Activins; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001219:Aspartate Aminotransferases / Q000097:blood; D015415:Biomarkers / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000097:blood* / Q000175:diagnosis / Q000378:metabolism / Q000473:pathology; D005260:Female; D006801:Humans; D007265:Inhibins / Q000097:blood* / Q000235:genetics; D008103:Liver Cirrhosis / Q000097:blood / Q000378:metabolism / Q000473:pathology; D008113:Liver Neoplasms / Q000097:blood* / Q000175:diagnosis / Q000378:metabolism / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010455:Peptides / Q000235:genetics / Q000378:metabolism; D029584:Prostatic Secretory Proteins; D012333:RNA, Messenger / Q000032:analysis; D000509:alpha-Fetoproteins / Q000378:metabolism
D015415:Biomarkers; D010455:Peptides; D029584:Prostatic Secretory Proteins; D012333:RNA, Messenger; D000509:alpha-Fetoproteins; C043076:beta-microseminoprotein; D028341:Activins; D007265:Inhibins; D001219:Aspartate Aminotransferases