title: Rising plasma nociceptin level during development of HCC: a case report.
abstract: OBJECTIVE
  Although liver cirrhosis is a predisposing factor for hepatocellular carcinoma (HCC), relatively few reports are available on HCC in primary biliary cirrhosis. High plasma nociceptin (N/OFQ) level has been shown in Wilson disease and in patients with acute and chronic pain.
  
  
  METHODS
  We report a follow-up case of HCC, which developed in a patient with primary biliary cirrhosis. The tumor appeared 18 years after the diagnosis of PBC and led to death within two years. Alfa fetoprotein and serum nociceptin levels were monitored before and during the development of HCC. Nociceptin content was also measured in the tumor tissue.
  
  
  RESULTS
  The importance and the curiosity of the presented case was the novel finding of the progressive elevation of plasma nociceptin level up to 17-fold (172 pg/mL) above the baseline (9.2+/-1.8 pg/mL), parallel with the elevation of alpha fetoprotein (from 13 ng/mL up to 3 480 ng/mL) during tumor development. Nociceptin content was more than 15-fold higher in the neoplastic tissue (0.16 pg/mg) than that in the tumor-free liver tissue samples (0.01 pg/mg) taken during the autopsy.
  
  
  CONCLUSIONS
  Results are in concordance with our previous observation that a very high plasma nociceptin level may be considered as an indicator for hepatocellular carcinoma.
authors.affiliation: MD, PhD, 1st Department of Medicine, Semmelweis University, Budapest, Hungary.
authors.forename: Andrea
authors.initials: A
authors.lastname: Horvath
authors.forename: Aniko
authors.initials: A
authors.lastname: Folhoffer
authors.forename: Peter Laszlo
authors.initials: PL
authors.lastname: Lakatos
authors.forename: Judit
authors.initials: J
authors.lastname: Halosz
authors.forename: Gyorgy
authors.initials: G
authors.lastname: Illyes
authors.forename: Zsuzsa
authors.initials: Z
authors.lastname: Schaff
authors.forename: Monika Beatrix
authors.initials: MB
authors.lastname: Hantos
authors.forename: Kornelia
authors.initials: K
authors.lastname: Tekes
authors.forename: Ferenc
authors.initials: F
authors.lastname: Szalay
mesh_terms: D014408:Biomarkers, Tumor; D006528:Carcinoma, Hepatocellular / Q000097:blood* / Q000473:pathology*; D005260:Female; D006801:Humans; D008105:Liver Cirrhosis, Biliary / Q000097:blood / Q000473:pathology; D008113:Liver Neoplasms / Q000097:blood* / Q000473:pathology*; D008875:Middle Aged; D018847:Opioid Peptides / Q000097:blood*; D000097629:Nociceptin
chemical_list: D014408:Biomarkers, Tumor; D018847:Opioid Peptides; D000097629:Nociceptin