title: Serum proteoglycans as prognostic biomarkers of hepatocellular carcinoma in patients with alcoholic cirrhosis.
abstract: BACKGROUND
  Proteoglycans are involved in neoangiogenesis and transduction of oncogenic signals, two hallmarks of carcinogenesis.
  
  
  METHODS
  This study sought to assess the prognostic value of serum levels of three proteoglycans (endocan, syndecan-1, and glypican-3) and VEGF in 295 patients with alcoholic cirrhosis: 170 without hepatocellular carcinoma, 58 with early hepatocellular carcinoma, and 67 with advanced hepatocellular carcinoma at inclusion. We analyzed the association between proteoglycan levels and prognosis using Kaplan-Meier and Cox methods.
  
  
  RESULTS
  Serum levels of the three proteoglycans and VEGF were increased in patients with advanced hepatocellular carcinoma compared with those without hepatocellular carcinoma or with early hepatocellular carcinoma. In multivariate analysis, high levels of serum endocan (>5 ng/mL) were independently associated with death [HR, 2.84; 95% confidence interval (CI,) 1.18-6.84; P = 0.02], but not with hepatocellular carcinoma occurrence, in patients without hepatocellular carcinoma at baseline. High serum endocan (>5 ng/mL) and syndecan-1 (>50 ng/mL) levels were significantly associated with greater risk of tumor recurrence (P = 0.025) in patients with early hepatocellular carcinoma treated by radiofrequency ablation. In patients with advanced hepatocellular carcinoma, high serum levels of endocan (P = 0.004) and syndecan-1 (P = 0.006) were significantly associated with less favorable overall survival. However, only a high level of serum syndecan-1 (>50 ng/mL) was independently associated with greater risk of death (HR, 6.21 95% CI, 1.90-20.30; P = 0.0025).
  
  
  CONCLUSIONS
  Serum endocan and syndecan-1 are easily assessable prognostic serum biomarkers of overall survival in alcoholic cirrhosis with and without hepatocellular carcinoma.
  
  
  CONCLUSIONS
  These new biomarkers will be useful to manage patients with hepatocellular carcinoma developed on alcoholic cirrhosis.
authors.affiliation: Service d'Hépatologie, Hôpital Jean Verdier, AP-HP, Bondy, France. naultjc@gmail.com
authors.forename: Jean-Charles
authors.initials: JC
authors.lastname: Nault
authors.forename: Erwan
authors.initials: E
authors.lastname: Guyot
authors.forename: Christelle
authors.initials: C
authors.lastname: Laguillier
authors.forename: Sylvie
authors.initials: S
authors.lastname: Chevret
authors.forename: Nathalie
authors.initials: N
authors.lastname: Ganne-Carrie
authors.forename: Gisèle
authors.initials: G
authors.lastname: N'Kontchou
authors.forename: Michel
authors.initials: M
authors.lastname: Beaugrand
authors.forename: Olivier
authors.initials: O
authors.lastname: Seror
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Trinchet
authors.forename: Jessica
authors.initials: J
authors.lastname: Coelho
authors.forename: Philippe
authors.initials: P
authors.lastname: Lasalle
authors.forename: Nathalie
authors.initials: N
authors.lastname: Charnaux
authors.forename: Maryse
authors.initials: M
authors.lastname: Delehedde
authors.forename: Angela
authors.initials: A
authors.lastname: Sutton
authors.forename: Pierre
authors.initials: P
authors.lastname: Nahon
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood*; D006528:Carcinoma, Hepatocellular / Q000097:blood* / Q000150:complications / Q000473:pathology; D005260:Female; D006801:Humans; D008104:Liver Cirrhosis, Alcoholic / Q000097:blood* / Q000150:complications; D008113:Liver Neoplasms / Q000097:blood* / Q000150:complications / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D011509:Proteoglycans / Q000097:blood*; D012189:Retrospective Studies
chemical_list: D014408:Biomarkers, Tumor; D011509:Proteoglycans