title: Prognotic impact of serum follistatin in patients with hepatocellular carcinoma.
abstract: OBJECTIVE
  Follistatin (FST) is a glycoprotein expressed in most organs, which interacts with activins or other members of the transforming growth factor beta family. Recently, several reports have shown that FST regulates a variety of processes during tumor progression. Here, serum FST in patients with liver diseases was measured, and its clinical utility as a biomarker was assessed.
  
  
  METHODS
  Serum was collected from 162 patients (91 hepatocellular carcinoma [HCC], 43 liver cirrhosis, and 28 chronic hepatitis) as well as from 16 healthy volunteers. FST was quantified by enzyme-linked immunosorbent assays, and levels were compared with clinical parameters including survival of the HCC patients.
  
  
  RESULTS
  Median serum FST levels in HCC, liver cirrhosis, chronic hepatitis, and healthy volunteers were 1168, 1606, 1324, and 1661 pg/mL, respectively, not significantly different. In HCC patients, higher serum FST was associated with greater age, hepatitis C virus antibody-negativity, large tumor size, g-glutamyl transpeptidase, des-gamma carboxyprothrombin and presence of portal vein tumor thrombus. Survival of HCC patients with high FST levels was significantly shorter than for those with low levels (P = 0.004). Multivariate analysis revealed that in addition to large tumor size and presence of portal vein thrombus, high FST levels were independently correlated with poor prognosis (hazard ratio = 2.41, 95% confidence interval = 1.16-5.00, P = 0.02).
  
  
  CONCLUSIONS
  Serum FST levels are significantly associated with HCC prognosis and could represent a predictive biomarker in this disease.
authors: Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama City, Okayama, Japan. tomotake79@yahoo.co.jp
authors: Takeshi
authors: T
authors: Tomoda
authors: Kazuhiro
authors: K
authors: Nouso
authors: Koji
authors: K
authors: Miyahara
authors: Sayo
authors: S
authors: Kobayashi
authors: Hideaki
authors: H
authors: Kinugasa
authors: Junki
authors: J
authors: Toyosawa
authors: Hiroaki
authors: H
authors: Hagihara
authors: Kenji
authors: K
authors: Kuwaki
authors: Hideki
authors: H
authors: Onishi
authors: Shinichiro
authors: S
authors: Nakamura
authors: Fusao
authors: F
authors: Ikeda
authors: Yasuhiro
authors: Y
authors: Miyake
authors: Hidenori
authors: H
authors: Shiraha
authors: Akinobu
authors: A
authors: Takaki
authors: Kazuhide
authors: K
authors: Yamamoto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D038681:Follistatin / Q000097:blood*; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D011379:Prognosis
chemical_list: D014408:Biomarkers, Tumor; D038681:Follistatin
keywords: HCC; follistatin; prognosis