TY - JOUR
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.
PY - 2018
Y1 - 2018
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.
AB - 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.
KW - Bilirubin/blood
KW - Biomarkers, Tumor/blood
KW - Blood Platelets/pathology
KW - C-Reactive Protein/metabolism
KW - Carcinoma, Hepatocellular/blood
KW - Female
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
SN - 0030-2414
IS - 2
ER -