title: Increased activity of serum mitochondrial isoenzyme of creatine kinase in hepatocellular carcinoma patients predominantly with recurrence.
abstract: OBJECTIVE
  Mitochondrial isoenzyme of creatine kinase (MtCK) is reportedly highly expressed in hepatocellular carcinoma (HCC). Clinical relevance of serum MtCK activity in patients with HCC was assessed using a novel immuno-inhibition method.
  
  
  METHODS
  Among patients with cirrhosis caused by hepatitis B or C virus, 147 patients with HCC (12 with the first occurrence and 135 with recurrence) and 92 patients without HCC were enrolled.
  
  
  RESULTS
  Serum MtCK activity was higher in cirrhotic patients with HCC than in those without HCC or healthy subjects. Elevated serum MtCK activity in HCC patients decreased after radiofrequency ablation. In case of prediction of HCC, MtCK had a sensitivity of 62.6% and a specificity of 70.7% at a cut-off point of 8.0 U/L, with an area under the receiver operating curve of 0.722 vs. 0.713 for alpha-fetoprotein (AFP) and 0.764 for des-gamma-carboxy prothrombin (DCP). Among the HCC patients, serum MtCK activity was elevated in 52.9% individuals with serum AFP level < 20 ng/ml and 63.2% individuals with serum DCP level < 40 mAu/ml. Even in patients with a single HCC ≤ 2 cm, the sensitivity of serum MtCK activity for the prediction of HCC was 64.4%, which was comparable to the overall sensitivity. This increased activity was due to an increase in ubiquitous MtCK, not sarcomeric MtCK, and the enhanced mRNA expression of ubiquitous MtCK was observed in cell lines originating from HCCs in contrast to healthy liver tissues.
  
  
  CONCLUSIONS
  Serum MtCK activity merits consideration as a novel marker for HCC to be further tested as for its diagnostic and prognostic power.
authors.affiliation: Department of Clinical Laboratory Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
authors.forename: Yoko
authors.initials: Y
authors.lastname: Soroida
authors.forename: Ryunosuke
authors.initials: R
authors.lastname: Ohkawa
authors.forename: Hayato
authors.initials: H
authors.lastname: Nakagawa
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Satoh
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Yoshida
authors.forename: Hiroto
authors.initials: H
authors.lastname: Kinoshita
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Tateishi
authors.forename: Ryota
authors.initials: R
authors.lastname: Masuzaki
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Enooku
authors.forename: Shuichiro
authors.initials: S
authors.lastname: Shiina
authors.forename: Takahisa
authors.initials: T
authors.lastname: Sato
authors.forename: Shuntaro
authors.initials: S
authors.lastname: Obi
authors.forename: Tadashi
authors.initials: T
authors.lastname: Hoshino
authors.forename: Ritsuko
authors.initials: R
authors.lastname: Nagatomo
authors.forename: Shigeo
authors.initials: S
authors.lastname: Okubo
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Yokota
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Koike
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Yatomi
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Ikeda
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000201:enzymology*; D052281:Creatine Kinase, Mitochondrial Form / Q000097:blood* / Q000235:genetics; D005260:Female; D006801:Humans; D007527:Isoenzymes / Q000097:blood*; D008113:Liver Neoplasms / Q000201:enzymology*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000201:enzymology*; D011498:Protein Precursors / Q000097:blood; D011516:Prothrombin; D012333:RNA, Messenger / Q000032:analysis; D000509:alpha-Fetoproteins / Q000032:analysis
chemical_list: D015415:Biomarkers; D007527:Isoenzymes; D011498:Protein Precursors; D012333:RNA, Messenger; D000509:alpha-Fetoproteins; C008208:acarboxyprothrombin; D011516:Prothrombin; D052281:Creatine Kinase, Mitochondrial Form