Systematic evaluation of circulating inflammatory markers for hepatocellular carcinoma

Chan, Stephen L.; Chan, Anthony W.H.; Chan, Allen; Jian, Peiyong; Mo, Frankie; Chan, Charles; Mok, Kevin; Liu, Calvin; Chong, Charing Ching‐Ning; Chan, Anthony T.C.; Mok, Tony; Park, Yeon Hee

doi:10.1111/liv.13218

Cited by 38 publications

(35 citation statements)

References 43 publications

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“…The AUC for MTD groups of 3 different cutoff values [3-5] were statistically significant, and the highest AUC values of PLR (0.666) and CRP (0.656) were achieved for MTD groups (< 5/≥5 cm) ( p < 0.05). However, the AUC value of the lowest MTD group (< 2/≥2 cm) was not statistically significant for both the CRP level and PLR ( p < 0.05).…”

Section: Resultsmentioning

confidence: 88%

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C-Reactive Protein and Platelet-Lymphocyte Ratio as Potential Tumor Markers in Low-Alpha-Fetoprotein Hepatocellular Carcinoma

et al. 2018

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The hepatocellular carcinoma (HCC) tumor marker alpha-fetoprotein (AFP) is only elevated in about half of the HCC patients, limiting its usefulness in following the effects of therapy or screening. New markers are needed. It has been previously noted that the inflammation markers C-reactive protein (CRP) and platelet-lymphocyte ratio (PLR) are prognostically important and may reflect HCC aggressiveness. We therefore examined these 2 markers in a low-AFP HCC cohort and found that for HCCs > 2 cm, both markers significantly rise with an increasing maximum tumor diameter (MTD). We calculated the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and Youden index value for each marker, and their area-under-the-curve values for each MTD group. Patients were dichotomized into 2 groups based on the CRP and PLR from the receiver-operating characteristic curve analysis. In the logistic regression models of the 4 different MTD patient groups, CRP and PLR levels were statistically significant to estimate MTD in univariate logistic regression models of MTD groups > 2 cm. CRP and PLR were then combined, and the combination was statistically significant to estimate MTD groups of 3-, 4-, and 5-cm cutoffs. CRP and PLR thus have potential as tumor markers for low-AFP HCC patients, and possibly for screening.

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Section: Resultsmentioning

confidence: 88%

“…There is thus a need for additional tumor markers. It is increasingly clear that nontumor factors are also important in HCC prognosis [4, 5], including tumor microenvironment [6, 7]. The acute phase response protein C-reactive protein (CRP) has been shown to be associated with both inflammation [8] and HCC [9-11].…”

Section: Introductionmentioning

confidence: 99%

C-Reactive Protein and Platelet-Lymphocyte Ratio as Potential Tumor Markers in Low-Alpha-Fetoprotein Hepatocellular Carcinoma

et al. 2018

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“…CRP is synthesized in hepatic cells and rapidly released into the plasma in the presence of tissue injury, infection and malignant tumors (34,35). CRP is commonly used as a systemic inflammatory marker and is significantly associated with poor survival or recurrence of HCC (36,37). CRP level has even been considered an independent predictor of recurrence of HCC with PVTT (38).…”

Section: Discussionmentioning

confidence: 99%

Early risk warning system for distant metastasis of hepatitis B virus‑associated hepatocellular carcinoma with portal vein tumor thrombus

Zhao²,

Liu

et al. 2020

Oncol Lett

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Portal vein tumor thrombus (PVTT) promotes distant metastasis of hepatocellular carcinoma (HCC), which increases the mortality of patients with HCC and PVTT. The aim of the present study was to develop an early risk warning system for distant metastasis of hepatitis B virus (HBV)-associated primary HCC (HBV-HCC) with PVTT. Data from 346 patients (263 and 83 in the modeling and validation cohorts, respectively) who had received primary diagnoses of HBV-HCC and PVTT between January 2012 and June 2015 at Beijing Ditan Hospital (Beijing, China) were retrospectively examined. In the modeling cohort, univariate and multivariate logistic regression analyses were conducted to determine the factors that were significantly associated with distant metastasis. Furthermore, an early risk warning model for distant metastasis was proposed and validated through receiver operating characteristic curve analysis in the validation cohort. The results revealed that neutrophil to lymphocyte ratios of ≥2.31, red blood cell counts of ≥4.07x10 12 cells/l, C-reactive protein levels of ≥7.02 mg/l, aspartate aminotransferase levels of ≥118.5 U/l and tumor thrombus site (at branch) were significantly positively associated with distant metastasis of HBV-HCC with PVTT (P<0.05; odds ratio >1.000). A formula for predicting distant metastasis was obtained with an accuracy of ~70%. The results of the present study may allow for the early prediction of distant metastasis and facilitate the administration of appropriate treatment to improve the outcomes and prognosis of patients with intermediate to advanced HCC.

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“…CRP is one of the best known amongst several inflammatory cytokines that are thought to be important in cancer [17,18,28]. They include both interleukins, interferons and Tumor necrosis factor-α [46-57].…”

Section: Discussionmentioning

confidence: 99%

The patient burden of opioidinduced bowel dysfunction

Akkız

Guerra

et al. 2018

clinical-practice

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C-reactive protein (CRP) is a blood marker for inflammation and is an independent prognostic factor for many human cancers. Combined with albumin levels, it forms the basis of the Glasgow Index for cancer prognosis. We reviewed the literature on CRP and HCC and also evaluated blood CRP levels and combination CRP plus albumin levels in a large HCC cohort. In order to understand the prognostic significance of CRP, we retrospectively examined a large HCC cohort and examined the relationship of CRP levels to tumor parameters. We report, that CRP alone and CRP plus albumin combined as well, significantly correlated with parameters of HCC aggressiveness, such as maximum tumor dimension (MTD), portal vein thrombosis (PVT) and blood alpha-fetoprotein (AFP) levels, both as individual parameters and all parameters together (Aggressiveness Index). This extends current thinking, to suggest a possible explanation for the usefulness of blood CRP levels in HCC prognostication.

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Systematic evaluation of circulating inflammatory markers for hepatocellular carcinoma

Abstract: Among the conventional and exploratory circulating inflammatory markers, higher CRP, lower albumin and higher interleukin-8 were independent prognosticators. By combining these factors, a simple and accurate inflammatory index could be constructed.

Cited by 38 publications

References 43 publications

C-Reactive Protein and Platelet-Lymphocyte Ratio as Potential Tumor Markers in Low-Alpha-Fetoprotein Hepatocellular Carcinoma

C-Reactive Protein and Platelet-Lymphocyte Ratio as Potential Tumor Markers in Low-Alpha-Fetoprotein Hepatocellular Carcinoma

Early risk warning system for distant metastasis of hepatitis B virus‑associated hepatocellular carcinoma with portal vein tumor thrombus

The patient burden of opioidinduced bowel dysfunction

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