Prognostic Value of Serum Caspase-Cleaved Cytokeratin-18 Levels before Liver Transplantation for One-Year Survival of Patients with Hepatocellular Carcinoma.
Cytokeratin (CK)-18 is the major intermediate filament protein in the liver and during hepatocyte apoptosis is cleaved by the action of caspases; the resulting fragments are released into the blood as caspase-cleaved cytokeratin (CCCK)-18. Higher circulating levels of CCCK-18 have been found in patients with hepatocellular carcinoma (HCC) than in healthy controls and than in cirrhotic patients. However, it is unknown whether serum CCCK-18 levels before liver transplantation (LT) in patients with HCC could be used as a prognostic biomarker of one-year survival, and this was the objective of our study with 135 patients. At one year after LT, non-survivors showed higher serum CCCK-18 levels than survivors (p = 0.001). On binary logistic regression analysis, serum CCCK-18 levels >384 U/L were associated with death at one year (odds ratio = 19.801; 95% confidence interval = 5.301-73.972; p < 0.001) after controlling for deceased donor age. The area under the receiver operating characteristic (ROC) curve of serum CCCK-18 levels to predict death at one year was 77% (95% CI = 69%-84%; p < 0.001). The new finding of our study was that serum levels of CCCK-18 before LT in patients with HCC could be used as prognostic biomarker of survival.
Intensive Care Unit, Hospital Universitario de Canarias, Ofra, s/n. La Laguna, Tenerife 38320, Spain. lorentemartin@msn.com.
Leonardo
L
Lorente
Intensive Care Unit, Hospital Universitario Nuestra Señora Candelaria, Crta Rosario s/n, Santa Cruz Tenerife 38010, Spain. sergiotomasr@hotmail.com.
Sergio T
ST
Rodriguez
Deparment of Surgery, Hospital Universitario Nuestra Señora de Candelaria, Crta Rosario s/n, Santa Cruz Tenerife 38010, Spain. sanzpereda@gmail.com.
Pablo
P
Sanz
Laboratory Deparment, Hospital Universitario de Canarias, Ofra, s/n. La Laguna, Tenerife 38320, Spain. aperezcejas@gmail.com.
Antonia
A
Pérez-Cejas
Deparment of Surgery, Hospital Universitario Nuestra Señora de Candelaria, Crta Rosario s/n, Santa Cruz Tenerife 38010, Spain. javipq@me.com.
Javier
J
Padilla
Deparment of Digestive, Hospital Universitario Nuestra Señora de Candelaria, Crta Rosario s/n, Santa Cruz Tenerife 38010, Spain. ddiazbet@gmail.com.
Dácil
D
Díaz
Deparment of Digestive, Hospital Universitario Nuestra Señora de Candelaria, Crta Rosario s/n, Santa Cruz Tenerife 38010, Spain. angonrod@gobiernodecanarias.org.
Antonio
A
González
Intensive Care Unit, Hospital Universitario Nuestra Señora Candelaria, Crta Rosario s/n, Santa Cruz Tenerife 38010, Spain. mar.martinvelasco@gmail.com.
María M
MM
Martín
Research Unit, Hospital Universitario de Canarias, Ofra, s/n. La Laguna, Tenerife 38320, Spain. ajimenezsosa@gmail.com.
Alejandro
A
Jiménez
Deparment of Surgery, Hospital Universitario Nuestra Señora de Candelaria, Crta Rosario s/n, Santa Cruz Tenerife 38010, Spain. mbargom@yahoo.es.
Manuel A
MA
Barrera
D015415:Biomarkers / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000097:blood* / Q000628:therapy; D020169:Caspases / Q000378:metabolism; D005260:Female; D006801:Humans; D053538:Keratin-18 / Q000097:blood / Q000737:chemistry*; D008113:Liver Neoplasms / Q000097:blood* / Q000628:therapy; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000097:blood*; D011379:Prognosis; D012372:ROC Curve; D016019:Survival Analysis
D015415:Biomarkers; C488421:KRT18 protein, human; D053538:Keratin-18; D010446:Peptide Fragments; D020169:Caspases
cytokeratin; hepatocellular carcinoma; liver transplantation; mortality; outcome