title: Prognostic value of serum biological markers in patients with hepatocellular carcinoma.
abstract: OBJECTIVE
  Prognosis of patients with hepatocellular carcinoma (HCC) is assessed by using indexes based on clinical and instrumental parameters. The Cancer of the Liver Italian Program (CLIP) staging system combines the Child-Pugh classification with tumor size, portal invasion, and alpha-fetoprotein and predicts the outcome of HCC patients more precisely than the Okuda staging system. Serum levels of a number of biological variables have been found to be increased in patients with HCC and are associated with different outcomes. Our aims in this study were to test the prognostic role of the serum levels of soluble intercellular adhesion molecule-1 (sICAM-1), soluble interleukin-2 receptor (sIL-2R), interleukin 6 (IL-6), and anti-p53 and to assess whether the addition of any of the above serum markers could further improve the predictive ability of the CLIP score.
  
  
  METHODS
  Serum levels of sICAM-1, sIL-2R, IL-6, and anti-p53 were assayed in 80 patients with HCC and correlated with their outcomes. Nonparametric procedures were applied to test correlations between serum sICAM-1, sIL-2R, IL-6, anti-p53, and other prognostic factors. For survival analyses, the product-limit method, log-rank test, and Cox proportional hazards model were applied.
  
  
  RESULTS
  Only serum levels of sIL-2R correlated with survival, which was longer for patients with lower values (< or =950 units/ml). However, with multivariate analysis sIL-2R did not confirm its predictive role when tested with the CLIP score as a covariate, with a hazard of death of 1.51 (95% confidence interval, 0.76-3.01).
  
  
  CONCLUSIONS
  Serum levels of sICAM-1, sIL-2R, IL-6, and anti-p53 are not useful as prognostic factors for HCC in clinical practice. They do not improve the predictive ability of the CLIP score.
authors.affiliation: Division of Clinical Immunology, National Cancer Institute, Via M. Semmola, 80131 Naples, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Parasole
authors.forename: F
authors.initials: F
authors.lastname: Izzo
authors.forename: F
authors.initials: F
authors.lastname: Perrone
authors.forename: S
authors.initials: S
authors.lastname: Pignata
authors.forename: M G
authors.initials: MG
authors.lastname: Galati
authors.forename: E
authors.initials: E
authors.lastname: Leonardi
authors.forename: F
authors.initials: F
authors.lastname: Castiglione
authors.forename: R
authors.initials: R
authors.lastname: Orlando
authors.forename: G
authors.initials: G
authors.lastname: Castello
authors.forename: G
authors.initials: G
authors.lastname: Esposito
authors.forename: C
authors.initials: C
authors.lastname: Gallo
authors.forename: B
authors.initials: B
authors.lastname: Daniele
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D000906:Antibodies / Q000097:blood; D015415:Biomarkers / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000473:pathology*; D005260:Female; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D008113:Liver Neoplasms / Q000097:blood / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D015375:Receptors, Interleukin-2 / Q000097:blood; D012995:Solubility; D016019:Survival Analysis; D016159:Tumor Suppressor Protein p53 / Q000276:immunology
chemical_list: D000906:Antibodies; D015415:Biomarkers; D015850:Interleukin-6; D015375:Receptors, Interleukin-2; D016159:Tumor Suppressor Protein p53; D018799:Intercellular Adhesion Molecule-1