Serum proteoglycans as prognostic biomarkers of hepatocellular carcinoma in patients with alcoholic cirrhosis
Menée sur 295 patients présentant une cirrhose alcoolique, dont 125 ayant développé un carcinome hépatocellulaire de stade précoce ou avancé, cette étude évalue, du point de vue de la récidive et de la survie globale, la valeur pronostique du niveau sérique de trois protéoglycanes (endocan, syndécane-1 et glypicane-3) et du facteur de croissance VEGF
Background : Proteoglycans are involved in neo-angiogenesis and transduction of oncogenic signals, two hallmarks of carcinogenesis.
Methods : This study sought to assess the prognostic value of serum levels of three proteoglycans (endocan, syndecan-1 and glypican-3) and VEGF in 295 patients with alcoholic cirrhosis : 170 without hepatocellular carcinoma (HCC), 58 with early HCC and 67 with advanced HCC at inclusion. We analyzed the association between proteoglycan levels and prognosis using Kaplan-Meier and Cox methods.
Results : Serum levels of the 3 proteoglycans and VEGF were increased in patients with advanced HCC compared to those without HCC or with early HCC. In multivariate analysis, high levelsof serum endocan (>5 ng/ml) were independently associated with death (HR 2.84 [1.18; 6.84] P =0.02), but not with HCC occurrence, in patients without HCC at baseline. High serum endocan (> 5 ng/ml) and syndecan-1 (> 50 ng/ml) levels were significantly associated with greater risk of tumor recurrence (P = 0.025) in patients with early HCC treated by radiofrequency ablation. In patients with advanced HCC, high serum levels of endocan (P =0.004) and syndecan-1 (P =0.006) were significantly associated with less favorable overall survival. However, only a high level of serum syndecan-1 (>50 ng/ml) was independently associated with greater risk of death (HR: 6.21 [1.90; 20.30] P=0.0025).
Conclusions : Serum endocan and syndecan-1 are easily assessable prognostic serum biomarkers of overall survival in alcoholic cirrhosis with and without HCC.
Impact : These new biomarkers will be useful to manage patients with HCC developed on alcoholic cirrhosis
Cancer Epidemiology Biomarkers & Prevention , résumé, 2013