Quantitation of tissue polypeptide antigen (TPA) in hepatic and systemic circulation in patients with chronic liver diseases.
OBJECTIVE
Abnormal serum tissue polypeptide antigen (TPA) values are commonly found in patients with chronic liver damage and liver cirrhosis even in the absence of malignancies. The aim of this study was to compare serum TPA levels in patients with cirrhosis, to examine correlations between TPA levels and the degree of portal hypertension, and to evaluate TPA concentrations in paired hepatic and peripheral blood samples.


METHODS
A total of 128 patients with chronic liver disease of various severity were studied prospectively. TPA concentrations in hepatic vein and peripheral blood were determined, and Hepatic Vein Pressure Gradient (HVPG) was measured.


RESULTS
TPA levels were significantly higher in patients with cirrhosis than in those with chronic hepatitis, and in systemic circulation than in hepatic vein blood. Peripheral but not hepatic TPA levels did correlate with the HVPG. Subjects with clinically significant portal hypertension (HVPG > 10 mmHg) showed significantly higher peripheral TPA levels than those with HVPG < 10 mmHg.


CONCLUSIONS
Our data suggest that the increased TPA levels observed in cirrhotic patients and the high systemic-to-hepatic blood TPA gradient are probably due to the presence of portal-systemic shunts rather than to hepatic necro-inflammatory activity. In clinical practice, TPA determination could help us to identify and to follow up cirrhotic patients with more severe portal hypertension.
Puoti
Claudio
C
Department of Internal Medicine and Liver Unit, Marino General Hospital, Rome, Italy. puoti@epatologia.org
Bellis
Lia
L
Guarisco
Riccardo
R
Costanza
Olga Mitidieri
OM
Felici
Renata
R
Spilabotti
Lucia
L
Paglia
Federica
F
Galossi
Alessandra
A
Dell' Unto
Orlando
O
D000368:Aged; D015415:Biomarkers / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000276:immunology; D005260:Female; D006503:Hepatic Veins / Q000503:physiopathology; D019694:Hepatitis B, Chronic / Q000276:immunology; D019698:Hepatitis C, Chronic / Q000276:immunology; D006801:Humans; D006975:Hypertension, Portal / Q000276:immunology* / Q000503:physiopathology; D008102:Liver Circulation; D008103:Liver Cirrhosis / Q000276:immunology; D008107:Liver Diseases / Q000150:complications / Q000276:immunology* / Q000503:physiopathology; D008113:Liver Neoplasms / Q000276:immunology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012720:Severity of Illness Index; D019396:Tissue Polypeptide Antigen / Q000097:blood*; D014690:Venous Pressure
D015415:Biomarkers; D019396:Tissue Polypeptide Antigen