title: Clinical significance of urinary N1,N12-diacetylspermine levels in patients with hepatocellular carcinoma.
abstract: OBJECTIVE
  N1,N12-diacetylspermine (DiAcSpm), a diacetylpolyamine which was recently identified in urine, appeared to be a useful tumor marker for urogenital cancers. Here we examined the clinical significance of urinary DiAcSpm as a tumor marker for hepatocellular carcinoma (HCC).
  
  
  METHODS
  Urine samples were collected from patients with HCC and benign liver diseases. Urinary levels of DiAcSpm were measured by ELISA, which was newly developed in order to analyze large numbers of samples.
  
  
  RESULTS
  The appropriate threshold value was set at 325 nM/g x creatinine. The sensitivity of the DiAcSpm assay for HCC was 65.5% and the specificity calculated between HCC and liver cirrhosis was 76.0%. The percentage of DiAcSpm-positive HCC patients was similar to that for AFP or PIVKA-II. At more advanced clinical stages, the positive percentage of these three markers increased but the DiAcSpm levels appeared to move independently of AFP and PIVKA-II. In HCC patients, the DiAcSpm levels reflected the progression of disease or the effect of treatment.
  
  
  CONCLUSIONS
  DiAcSpm levels were found to reflect the severity, activity or viability of HCC. Urinary DiAcSpm can therefore be considered one of the useful indexes for patients with HCC.
authors.affiliation: Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. enjoji@intmed3.med.kyushu-u.ac.jp
authors.forename: M
authors.initials: M
authors.lastname: Enjoji
authors.forename: M
authors.initials: M
authors.lastname: Nakamuta
authors.forename: E
authors.initials: E
authors.lastname: Arimura
authors.forename: S
authors.initials: S
authors.lastname: Morizono
authors.forename: M
authors.initials: M
authors.lastname: Kuniyoshi
authors.forename: M
authors.initials: M
authors.lastname: Fukushima
authors.forename: K
authors.initials: K
authors.lastname: Kotoh
authors.forename: H
authors.initials: H
authors.lastname: Nawata
mesh_terms: D015415:Biomarkers / Q000652:urine; D014408:Biomarkers, Tumor; D006528:Carcinoma, Hepatocellular / Q000652:urine*; D003404:Creatinine / Q000378:metabolism; D004797:Enzyme-Linked Immunosorbent Assay; D005189:False Positive Reactions; D006801:Humans; D008099:Liver / Q000378:metabolism; D008103:Liver Cirrhosis / Q000652:urine; D008113:Liver Neoplasms / Q000652:urine*; D011073:Polyamines / Q000652:urine; D011498:Protein Precursors / Q000652:urine; D011516:Prothrombin / Q000652:urine; D012372:ROC Curve; D012680:Sensitivity and Specificity; D013096:Spermine / Q000031:analogs & derivatives* / Q000652:urine*; D013997:Time Factors; D000509:alpha-Fetoproteins / Q000652:urine
chemical_list: D015415:Biomarkers; D014408:Biomarkers, Tumor; D011073:Polyamines; D011498:Protein Precursors; D000509:alpha-Fetoproteins; D013096:Spermine; C008208:acarboxyprothrombin; C029453:N',N''-diacetylspermine; D011516:Prothrombin; D003404:Creatinine