title: High preoparative levels of serum periostin are associated with poor prognosis in patients with hepatocellular carcinoma after hepatectomy.
abstract: OBJECTIVE
  Periostin (POSTN) is implicated in cancer development and progression. The aim of this study was to evaluate the diagnostic and prognostic significance of serum POSTN in patients with hepatocellular carcinoma (HCC) receiving curative surgery.
  
  
  METHODS
  Enzyme-linked immunosorbent assay was performed to determine serum POSTN levels in 69 healthy volunteers, 30 patients with hepatolithiasis, 27 patients with cirrhosis, and 56 HCC patients. The relationships between serum POSTN and clinicopathologic features were analyzed. Receiver operating characteristics analysis was used to calculate diagnostic accuracy of serum POSTN, serum alpha-fetoprotein (AFP), and their combination. The prognostic impact of serum POSTN on overall survival (OS) and relapse-free survival (RFS) was also investigated.
  
  
  RESULTS
  The median serum POSTN level was significantly (P < 0.05) increased in HCC patients, compared to healthy controls, patients with hepatolithiasis, and patients with liver cirrhosis. Elevated serum POSTN was only significantly associated with Edmondson grade (P = 0.007). The combination of serum POSTN and AFP had a markedly higher area under the curve (0.805 (95% confidence interval [CI]: 0.677-0.932)) than POSTN (0.582 (95% CI: 0.427-0.736)) or AFP (0.655 (95% CI: 0.504-0.806)) alone. Kaplan-Meier analysis indicated that elevated serum POSTN was associated with OS (P = 0.031) and RFS (P = 0.027). Moreover, multivariate analysis revealed elevated serum POSTN as an independent poor prognostic marker for OS and RFS.
  
  
  CONCLUSIONS
  Preoperative serum POSTN has limited diagnostic value in distinguishing HCC from non-malignant liver diseases, but serves as independent prognostic biomarker in HCC patients.
authors.affiliation: Anhui Province Key Laboratory of Hepatopancreatobiliary Surgery, Anhui Provincial Hospital, Hefei 230001, PR China; Department of Plastic Surgery, The Second Hospital of Anhui Medical University, Hefei 230601, PR China.
authors.forename: Y
authors.initials: Y
authors.lastname: Lv
authors.forename: W
authors.initials: W
authors.lastname: Wang
authors.forename: W D
authors.initials: WD
authors.lastname: Jia
authors.forename: Q K
authors.initials: QK
authors.lastname: Sun
authors.forename: M
authors.initials: M
authors.lastname: Huang
authors.forename: H C
authors.initials: HC
authors.lastname: Zhou
authors.forename: H H
authors.initials: HH
authors.lastname: Xia
authors.forename: W B
authors.initials: WB
authors.lastname: Liu
authors.forename: H
authors.initials: H
authors.lastname: Chen
authors.forename: S N
authors.initials: SN
authors.lastname: Sun
authors.forename: G L
authors.initials: GL
authors.lastname: Xu
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000097:blood* / Q000473:pathology / Q000601:surgery*; D016022:Case-Control Studies; D015815:Cell Adhesion Molecules / Q000097:blood*; D002681:China; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood* / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D000509:alpha-Fetoproteins / Q000378:metabolism
chemical_list: D014408:Biomarkers, Tumor; D015815:Cell Adhesion Molecules; C512835:POSTN protein, human; D000509:alpha-Fetoproteins
keywords: AFP; DFS; ECM; HBV; HCC; Hepatocellular carcinoma; NSCLC; OPN; OS; POSTN; Periostin; Prognosis; RFS; TNM; alpha-fetoprotein; disease-free survival; extracellular matrix; hepatitis B viral; hepatocellular carcinoma; non-small cell lung cancer; osteopontin; overall survival; periostin; relapse-free survival; tumor-node-metastasis