Serum insulin-like growth factor I evaluation as a useful tool for predicting the risk of developing hepatocellular carcinoma in patients with hepatitis C virus-related cirrhosis a prospective study

Gherardo Mazziotti, Francesca Sorvillo, Filomena Morisco, Antonella Carbone, Mario Rotondi, Gianfranca Stornaiuolo, Davide F. Precone, Michele Cioffi, Giovanni B. Gaeta, Nicola Caporaso, Carlo Carella

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND. Although experimental studies have demonstrated an important role of insulin-like growth factor I (IGF-I) in hepatocarcinogenesis, the clinical data about IGF-I in patients with hepatocellular carcinoma (HCC) are scarce and controversial. To the authors' knowledge, this is the first prospective study investigating the longitudinal correlation between modifications in serum IGF-I levels and the development of HCC in a cohort of patients with hepatitis C virus (HCV)-related cirrhosis. METHODS. One hundred fourteen consecutive patients with HCV-related Child Grade A cirrhosis were followed prospectively at the Second University of Naples for 56.4 ± 12.0 months with ultrasound examinations of the liver and serum α-fetoprotein determination every 6 months. At each clinical evaluation, the severity of disease was graded according to the established Child-Pugh scoring system. Serum IGF-I levels were measured prospectively at the study entry and at least every 12 months throughout follow-up. RESULTS. Twenty patients (19.2%) developed HCC during follow-up. Eleven of these patients had persistent Child Grade A cirrhosis for the whole study, whereas the other 9 patients developed HCC after their cirrhosis progressed from Child Grade A to Grade B. In patients who remained free of HCC for the whole study, serum IGF-I concentrations did not modify significantly during follow-up. Conversely, in patients who developed HCC, IGF-I levels decreased significantly during follow-up (from 72.6 ± 29.9 μg/L to 33.8 ± 14.5 μg/L; P = 0.001). In these patients, the significant decrease occurred both in patients with persistent Child Grade A cirrhosis and in patients with cirrhosis that progressed from Child Grade A to Grade B. The reduction in IGF-I level preceded the diagnosis of HCC by 9.3 ± 3.1 months. CONCLUSIONS. This prospective study demonstrates that, in patients with HCV-related cirrhosis, 1) the development of HCC is accompanied by a significant reduction of serum IGF-I levels independent of the grade of impairment of liver function; and 2) modification of the IGF-I level precedes the morphologic appearance of HCC, permitting a precocious diagnosis of the tumor.

Original languageEnglish
Pages (from-to)2539-2545
Number of pages7
JournalCancer
Volume95
Issue number12
DOIs
Publication statusPublished - Dec 15 2002

Keywords

  • α-fetoprotein
  • Diagnostic accuracy
  • Hepatocellular carcinoma
  • Hepatocellular carcinoma surveillance
  • Insulin-like growth factor axis
  • Insulin-like growth factor I

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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