Characteristics of Hepatocellular Carcinoma Aggressiveness Factors in Turkish Patients

Hikmet Akkiz, Brian I Carr, Kendal Yalçın K, Vito Guerra, Sedef Kuran, Engin Altıntaş, Oğuz Üsküdar, Ümit Karaoğullarından, Ayşegül Özakyol, Salih Tokmak, Mehmet Yücesoy, Halil İbrahim Bahçeci, Abdulalh Ülkü, Tolga Akçam, Kamil Yalçın Polat, Nazım Ekinci, Halis Şimşek, Necati Örmeci, Abdulalh Sonsuz, Mehmet DemirMurat Kılıç, Ahmet Uygun, Tuğsan Ballı, Ali Demir, Burcu Arslan, Figen Doran

Research output: Contribution to journalArticle

Abstract

A large cohort of hepatocellular carcinoma (HCC) patients from several collaborating Turkish institutions were examined for the tumor parameters of maximum diameter (MTD), portal vein thrombosis (PVT), and α-fetoprotein (AFP) levels. A relationship was found between MTD and blood platelet levels. Patients with large ≥5 cm tumors who had normal platelet levels had significantly larger tumors, higher percent of PVT, and significantly lower blood total bilirubin and liver cirrhosis than similar ≥5 cm tumor patients having thrombocytopenia. A comparison of patients with and without PVT showed significantly larger tumors, greater multifocality, blood AFP, and C-reactive protein levels, and, interestingly, lower HDL levels in the patients with PVT. Fifty-eight percent of the total cohort had AFP levels ≤100 IU/mL (and 42.1% had values ≤20 IU/mL). These patients had significantly smaller tumors, less tumor multifocality and percent PVT, lower total bilirubin, and less cirrhosis. There was considerable geographic heterogeneity within Turkey in the patterns of HCC presentation, with areas of higher and lower hepatitis B virus, hepatitis D virus, cirrhosis, and tumor aggressiveness parameters. Turkish patients thus have distinct patterns of presentation, but the biological relationships between MTD and both platelets and bilirubin levels are similar to the relationships that have been reported in other ethnic patient groups.

Original languageEnglish
Pages (from-to)116-124
Number of pages9
JournalOncology
Volume94
Issue number2
DOIs
Publication statusPublished - 2018

Fingerprint

Hepatocellular Carcinoma
Portal Vein
Fetal Proteins
Thrombosis
Neoplasms
Bilirubin
Blood Platelets
Fibrosis
Hepatitis Delta Virus
Turkey
Ethnic Groups
Hepatitis B virus
Liver Cirrhosis
Thrombocytopenia
C-Reactive Protein

Keywords

  • Bilirubin/blood
  • Biomarkers, Tumor/blood
  • Blood Platelets/pathology
  • C-Reactive Protein/metabolism
  • Carcinoma, Hepatocellular/blood
  • Female
  • Humans
  • Liver Cirrhosis/blood
  • Liver Function Tests/methods
  • Liver Neoplasms/blood
  • Male
  • Middle Aged
  • Portal Vein/pathology
  • Prognosis
  • Prospective Studies
  • Thrombocytopenia/blood
  • Turkey
  • Venous Thrombosis/blood
  • alpha-Fetoproteins/metabolism

Cite this

Akkiz, H., Carr, B. I., Yalçın K, K., Guerra, V., Kuran, S., Altıntaş, E., ... Doran, F. (2018). Characteristics of Hepatocellular Carcinoma Aggressiveness Factors in Turkish Patients. Oncology, 94(2), 116-124. https://doi.org/10.1159/000484564

Characteristics of Hepatocellular Carcinoma Aggressiveness Factors in Turkish Patients. / Akkiz, Hikmet; Carr, Brian I; Yalçın K, Kendal; Guerra, Vito; Kuran, Sedef; Altıntaş, Engin; Üsküdar, Oğuz; Karaoğullarından, Ümit; Özakyol, Ayşegül; Tokmak, Salih; Yücesoy, Mehmet; Bahçeci, Halil İbrahim; Ülkü, Abdulalh; Akçam, Tolga; Yalçın Polat, Kamil; Ekinci, Nazım; Şimşek, Halis; Örmeci, Necati; Sonsuz, Abdulalh; Demir, Mehmet; Kılıç, Murat; Uygun, Ahmet; Ballı, Tuğsan; Demir, Ali; Arslan, Burcu; Doran, Figen.

In: Oncology, Vol. 94, No. 2, 2018, p. 116-124.

Research output: Contribution to journalArticle

Akkiz, H, Carr, BI, Yalçın K, K, Guerra, V, Kuran, S, Altıntaş, E, Üsküdar, O, Karaoğullarından, Ü, Özakyol, A, Tokmak, S, Yücesoy, M, Bahçeci, Hİ, Ülkü, A, Akçam, T, Yalçın Polat, K, Ekinci, N, Şimşek, H, Örmeci, N, Sonsuz, A, Demir, M, Kılıç, M, Uygun, A, Ballı, T, Demir, A, Arslan, B & Doran, F 2018, 'Characteristics of Hepatocellular Carcinoma Aggressiveness Factors in Turkish Patients', Oncology, vol. 94, no. 2, pp. 116-124. https://doi.org/10.1159/000484564
Akkiz, Hikmet ; Carr, Brian I ; Yalçın K, Kendal ; Guerra, Vito ; Kuran, Sedef ; Altıntaş, Engin ; Üsküdar, Oğuz ; Karaoğullarından, Ümit ; Özakyol, Ayşegül ; Tokmak, Salih ; Yücesoy, Mehmet ; Bahçeci, Halil İbrahim ; Ülkü, Abdulalh ; Akçam, Tolga ; Yalçın Polat, Kamil ; Ekinci, Nazım ; Şimşek, Halis ; Örmeci, Necati ; Sonsuz, Abdulalh ; Demir, Mehmet ; Kılıç, Murat ; Uygun, Ahmet ; Ballı, Tuğsan ; Demir, Ali ; Arslan, Burcu ; Doran, Figen. / Characteristics of Hepatocellular Carcinoma Aggressiveness Factors in Turkish Patients. In: Oncology. 2018 ; Vol. 94, No. 2. pp. 116-124.
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T1 - Characteristics of Hepatocellular Carcinoma Aggressiveness Factors in Turkish Patients

AU - Akkiz, Hikmet

AU - Carr, Brian I

AU - Yalçın K, Kendal

AU - Guerra, Vito

AU - Kuran, Sedef

AU - Altıntaş, Engin

AU - Üsküdar, Oğuz

AU - Karaoğullarından, Ümit

AU - Özakyol, Ayşegül

AU - Tokmak, Salih

AU - Yücesoy, Mehmet

AU - Bahçeci, Halil İbrahim

AU - Ülkü, Abdulalh

AU - Akçam, Tolga

AU - Yalçın Polat, Kamil

AU - Ekinci, Nazım

AU - Şimşek, Halis

AU - Örmeci, Necati

AU - Sonsuz, Abdulalh

AU - Demir, Mehmet

AU - Kılıç, Murat

AU - Uygun, Ahmet

AU - Ballı, Tuğsan

AU - Demir, Ali

AU - Arslan, Burcu

AU - Doran, Figen

N1 - © 2017 S. Karger AG, Basel.

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N2 - A large cohort of hepatocellular carcinoma (HCC) patients from several collaborating Turkish institutions were examined for the tumor parameters of maximum diameter (MTD), portal vein thrombosis (PVT), and α-fetoprotein (AFP) levels. A relationship was found between MTD and blood platelet levels. Patients with large ≥5 cm tumors who had normal platelet levels had significantly larger tumors, higher percent of PVT, and significantly lower blood total bilirubin and liver cirrhosis than similar ≥5 cm tumor patients having thrombocytopenia. A comparison of patients with and without PVT showed significantly larger tumors, greater multifocality, blood AFP, and C-reactive protein levels, and, interestingly, lower HDL levels in the patients with PVT. Fifty-eight percent of the total cohort had AFP levels ≤100 IU/mL (and 42.1% had values ≤20 IU/mL). These patients had significantly smaller tumors, less tumor multifocality and percent PVT, lower total bilirubin, and less cirrhosis. There was considerable geographic heterogeneity within Turkey in the patterns of HCC presentation, with areas of higher and lower hepatitis B virus, hepatitis D virus, cirrhosis, and tumor aggressiveness parameters. Turkish patients thus have distinct patterns of presentation, but the biological relationships between MTD and both platelets and bilirubin levels are similar to the relationships that have been reported in other ethnic patient groups.

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KW - C-Reactive Protein/metabolism

KW - Carcinoma, Hepatocellular/blood

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KW - Humans

KW - Liver Cirrhosis/blood

KW - Liver Function Tests/methods

KW - Liver Neoplasms/blood

KW - Male

KW - Middle Aged

KW - Portal Vein/pathology

KW - Prognosis

KW - Prospective Studies

KW - Thrombocytopenia/blood

KW - Turkey

KW - Venous Thrombosis/blood

KW - alpha-Fetoproteins/metabolism

U2 - 10.1159/000484564

DO - 10.1159/000484564

M3 - Article

C2 - 29207378

VL - 94

SP - 116

EP - 124

JO - Oncology

JF - Oncology

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