Des-γ-carboxyprothrombin (DCP) and NX-DCP expressions and their relationship with clinicopathological features in hepatocellular carcinoma.
OBJECTIVE
Des-γ-carboxyprothrombin (DCP) has been used as a tumor marker for hepatocellular carcinoma (HCC). Recently the DCP/NX-DCP ratio, calculated by dividing DCP by NX-DCP, has been reported useful in detecting HCC. The purpose of this study is to clarify the significance of DCP and NX-DCP expression in HCC tissues.


METHODS
HCC and non-HCC tissue samples were obtained from 157 patients and were immunohistochemically examined for DCP and NX-DCP expression using anti-DCP antibody and anti-NX-DCP antibody. DCP and NX-DCP expression scores were calculated by multiplying staining intensity grade by percentage of stained area. Serum DCP and NX-DCP levels were determined in 89 patients. We evaluated the relationship between tumor expression, serum level, and pathomorphological findings.


RESULTS
Intrahepatic metastasis (im) was significantly more frequent in cases with high DCP expression than in cases with low DCP expression. High NX-DCP expression was associated with significantly lower histological grade, and less frequent im or portal vein invasion (vp) than low NX-DCP expression. Serum DCP was correlated with DCP expression, but serum NX-DCP was not correlated with NX-DCP expression. DCP-positive (≥40 mAU/L), NX-DCP-positive (≥90 mAU/L), and DCP/NX-DCP ratio-positive (≥1.5) cases were associated with significantly larger tumor size and more frequent vp than negative cases. DCP was rarely expressed, but NX-DCP was frequently expressed in non-cancerous liver tissues. Patients with NX-DCP expression-negative tumors showed a lower survival rate than those with NX-DCP expression-positive tumors (p = 0.04), whereas the survival in serum NX-DCP-positive cases was lower than that of serum negative cases (p = 0.02).


CONCLUSIONS
DCP and NX-DCP were produced in HCC tissues, but differed in expression level and biological properties. DCP expression, serum DCP or NX-DCP level, and DCP/NX-DCP ratio were closely related to malignant properties of HCC.
Department of Pathology, Kurume University School of Medicine, Kurume, Fukuoka, Japan; Department of Radiology, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
Akiko
A
Sumi
Department of Pathology, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
Jun
J
Akiba
Department of Pathology, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
Sachiko
S
Ogasawara
Department of Pathology, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
Masamichi
M
Nakayama
Department of Pathology, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
Yoriko
Y
Nomura
Department of Pathology, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
Makiko
M
Yasumoto
Department of Pathology, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
Sakiko
S
Sanada
Department of Clinical Laboratory Medicine, Kurume University Hospital, Kurume, Fukuoka, Japan.
Osamu
O
Nakashima
Department of Radiology, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
Toshi
T
Abe
Department of Pathology, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
Hirohisa
H
Yano
D015055:1-Carboxyglutamic Acid; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood / Q000737:chemistry / Q000378:metabolism*; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000378:metabolism* / Q000473:pathology*; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D008099:Liver / Q000378:metabolism; D008113:Liver Neoplasms / Q000097:blood / Q000378:metabolism* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011498:Protein Precursors / Q000097:blood / Q000737:chemistry / Q000378:metabolism*; D011516:Prothrombin / Q000737:chemistry / Q000378:metabolism*; D012189:Retrospective Studies
D015415:Biomarkers; D011498:Protein Precursors; C008208:acarboxyprothrombin; D015055:1-Carboxyglutamic Acid; D011516:Prothrombin