Serum Endocan as a Survival Predictor for Patients with Liver Cirrhosis

Abstract

BACKGROUND: The relationship between endocan expression and outcome in patients with chronic liver disease is not fully understood.OBJECTIVE: To examine whether serum endocan level is predictive of outcome in patients with liver cirrhosis.METHODS: A total of 68 patients with liver cirrhosis were enrolled. Outcome predictors were analyzed using the Cox proportional hazards model. The overall survival rates were calculated using the Kaplan-Meier method, and differences were evaluated using the log-rank test.RESULTS: During the median follow-up period (7.1 years), nine patients had hepatocellular carcinoma (HCC) and 10 patients died. Of the deceased patients, nine died due to hepatic decompensation or associated conditions. No significant factors were found to be predictive of the occurrence of HCC. In contrast, an elevated serum endocan level (≥2.0 ng/mL; HR 2.34 [95% CI 1.05 to 7.03]; P=0.037) and high Child-Pugh grade B/C (HR 2.65 [95% CI 1.30 to 6.89; P=0.006) were predictive of poor survival. Kaplan-Meier analysis revealed that the respective cumulative survival rates at five and 10 years were 97.1% and 87.4% in patients with serum endocan levels <2.0 ng/mL and 85.8% and 64.4% in patients with levels ≥2.0 ng/mL (P=0.009), respectively. Moreover, the cumulative survival rates were significantly different among the patient groups divided according to serum endocan level and Child-Pugh grade (P=0.002).CONCLUSION: These findings suggest that serum endocan level may be a survival predictor for patients with liver cirrhosis.

Endothelial GATA4 controls liver fibrosis and regeneration by preventing a pathogenic switch in angiocrine signaling

“…Interestingly, Sparcl1 is also induced in HSC in nonalcoholic steatohepatitis (NASH), but not toxic liver fibrosis [30]. Esm1 and Igfbp5 were also significantly regulated angiocrine factors in LSEC of Gata4 LSEC-KO mice and they are known biomarkers for liver fibrosis involved in HSC activation [31,32].…”

Endocan Serum Levels in Patients with Non-Alcoholic Fatty Liver Disease with or without Type 2 Diabetes Mellitus: A Pilot Study

“…Since ED seems to intervene in the pathogenesis and natural history of NAFLD, it might be useful to identify an ED biomarker in this setting. Recently, a novel serum biomarker called Endocan (ESM-1) has been found to predict the overall survival in patients with liver cirrhosis [22]. ESM-1 is a 50 kDa circulating proteoglycan specifically produced by non sinusoidal endothelial cells.…”

The diagnostic and prognostic value of serum endocan in patients with cirrhotic cardiomyopathy

“…In their study Toshikuni and his group [11] concluded that endocan might be an independent survival predictor for patients with cirrhosis. Our results also favour a role for endocan as a prognostic marker for worse outcome in cirrhosis.…”

“…Studies have convincingly shown that endocan is involved in the mechanisms of acute inflammation and neovascularization in various pathological conditions such as sepsis [3,4] and tumor progression [5] and recent data shows a role for endocan as an indicator of cardiovascular disease [6]. While its value as a diagnostic or prognostic marker for hepatocellular carcinoma is under investigation [7][8][9], there have been few papers on endocan in the setting of liver cirrhosis [10,11].…”