Low Alpha-Fetoprotein HCC and the Role of GGTP

2014 ◽  
Vol 29 (4) ◽  
pp. 395-402 ◽  
Author(s):  
Brian I. Carr ◽  
Vito Guerra ◽  
Edoardo G. Giannini ◽  
Fabio Farinati ◽  
Francesca Ciccarese ◽  
...  
Keyword(s):  
Survival Rates ◽  
Alpha Fetoprotein ◽  
Gamma Glutamyl Transpeptidase ◽  
Vein Thrombosis ◽  
Medical Centers ◽  
Tumor Multifocality ◽  
Small Hccs ◽  
Prognosis Marker ◽  
Glutamyl Transpeptidase

Background HCC patients are heterogeneous in terms of both tumor and liver factors. Alpha-fetoprotein (AFP) is an important prognostic tumor marker for those patients with elevated AFP levels. Aims To examine the differences in HCC patients with high or low AFP levels in blood and evaluate the prognostic parameters in low AFP patients. Methods A cohort of 2,440 HCC patients from 11 Italian medical centers was studied. AFP-positive patients were compared to AFP-negative ones, and the blood and tumor parameters of AFP-negative patients were examined. Results Low blood AFP levels were found in 58% of the total cohort, in 64% of patients with small HCCs, and in 51% of patients with large HCCs. In patients with large tumors, platelet and gamma glutamyl transpeptidase (GGTP) levels, tumor multifocality and portal vein thrombosis (PVT) incidence were all greater than in patients with small tumors, regardless of AFP status. Patients with higher AFP levels had worse survival rates than those with low AFP in each tumor size group. In patients with small tumors, the elevated AFP was associated with significantly increased PVT and worse survival. In patients with large tumors, the elevated AFP was associated with significantly higher GGTP, ALKP, and bilirubin levels, as well as with increased PVT and multifocality, and worse survival. Low-AFP patients with high GGTP levels had worse survival than patients with low GGTP levels. Conclusion Patients with low AFP were the majority in this cohort, and patients with elevated GGTP had worse prognosis than those with low GGTP. GGTP may be a useful tumor and prognosis marker in low-AFP patients. AFP-negative patients are important to identify due to their enhanced survival.

Significance of Platelet and AFP Levels and Liver Function Parameters for HCC Size and Survival

2014 ◽  
Vol 29 (3) ◽  
pp. 215-223 ◽  
Author(s):  
Brian I. Carr ◽  
Vito Guerra ◽  
Edoardo G. Giannini ◽  
Fabio Farinati ◽  
Francesca Ciccarese ◽  
...  
Keyword(s):  
Tumor Size ◽  
Blood Platelet ◽  
Tumor Diameter ◽  
Proportional Hazard ◽  
Gamma Glutamyl Transpeptidase ◽  
Vein Thrombosis ◽  
Risk Of Death ◽  
Cox Proportional Hazard ◽  
Maximum Tumor Diameter ◽  
Glutamyl Transpeptidase

Background Hepatocellular carcinoma (HCC) is a heterogeneous disease with both tumor and liver factors being involved. Aims To investigate HCC clinical phenotypes and factors related to HCC size. Methods Prospectively-collected HCC patients' data from a large Italian database were arranged according to the maximum tumor diameter (MTD) and divided into tumor size terciles, which were then compared in terms of several common clinical parameters and patients' survival. Results An higer MTD tercile was significantly associated with increased blood alpha-fetoprotein (AFP), gamma-glutamyl transpeptidase (GGTP), and platelet levels. Patients with higher platelet levels had larger tumors and higher GGTP levels, with lower bilirubin levels. However, patients with the highest AFP levels had larger tumors and higher bilirubin levels, reflecting an aggressive biology. AFP correlation analysis revealed the existence of 2 different groups of patients: those with higher and with lower AFP levels, each with different patient and tumor characteristics. The Cox proportional-hazard model showed that a higher risk of death was correlated with GGTP and bilirubin levels, tumor size and number, and portal vein thrombosis (PVT), but not with AFP or platelet levels. Conclusions An increased tumor size was associated with increased blood platelet counts, AFP and GGTP levels. Platelet and AFP levels were important indicators of tumor size, but not of survival.

Absence of a role of gamma-glutamyl transpeptidase in the transport of amino acids by rat renal brushborder membrane vesicles

1984 ◽  
Vol 80 (2) ◽  
pp. 167-173 ◽  
Author(s):  
Betty Y. L. Hsu ◽  
John W. Foreman ◽  
Susan M. Corcoran ◽  
Kristina Ginkinger ◽  
Stanton Segal
Keyword(s):  
Amino Acids ◽  
Membrane Vesicles ◽  
Gamma Glutamyl Transpeptidase ◽  
Gamma Glutamyl ◽  
Glutamyl Transpeptidase

scholarly journals Changes in hepatocellular carcinoma aggressiveness characteristics with an increase in tumor diameter

2021 ◽  
pp. 172460082199637
Author(s):  
Brian I. Carr ◽  
Vito Guerra ◽  
Rossella Donghia ◽  
Fabio Farinati ◽  
Edoardo G. Giannini ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Survival Data ◽  
Alpha Fetoprotein ◽  
Tumor Diameter ◽  
Vein Thrombosis ◽  
Tumor Multifocality ◽  
Maximum Tumor Diameter ◽  
Tumor Sampling

Background: Hepatocellular carcinoma prognosis depends on both liver and tumor determinants, especially on maximum tumor diameter, multifocality, and presence of portal vein thrombosis, despite apparently complete tumor removal by resection or liver transplantation. Aims: To examine parameters of hepatocellular carcinoma aggressiveness as tumor size increases. Methods: A large hepatocellular carcinoma database was examined for trends in serum alpha-fetoprotein and the percentage of patients with macroscopic portal vein thrombosis or tumor multifocality. Results: A total of 13,016 hepatocellular carcinoma patients were identified having full tumor and survival data. Of these, 76.56% were male and 23.44% were female, with a median age of 64.4 years. We found that as the maximum tumor diameter increased, there was a significant trend for increased alpha-fetoprotein levels ( P<0.001) and an increased percentage of patients with either portal vein thrombosis or tumor multifocality, each P<0.0001. Furthermore, the increases of both alpha-fetoprotein and portal vein thrombosis were proportionately greater than the related maximum tumor diameter increases. These trends of increased alpha-fetoprotein, portal vein thrombosis, and multifocality with increasing maximum tumor diameter had non-linear patterns. Within alpha-fetoprotein and multifocality trends, there were identifiable sub-trends associated with specific maximum tumor diameter ranges. Conclusions: The greater fold-increases in alpha-fetoprotein and portal vein thrombosis compared with increases in maximum tumor diameter imply that hepatocellular carcinoma characteristics may change with increasing size to a more aggressive phenotype, suggesting that follow-up tumor sampling might be useful, in addition to baseline tumor sampling, for optimal therapeutic choices to be made.

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