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Panminerva Medica 2008 September;50(3):221-6


lingua: Inglese

A study about mechanisms of des-gamma-carboxy prothrombin’s production in hepatocellular carcinoma

Bertino G. 1, Ardiri A. M. 1, Boemi P. M. 1, Ierna D. 1, Interlandi D. 1, Caruso L. 1, Minona E. 2, Trovato M. A. 2, Vicari S. 2, Li Destri G. 2, Puleo S. 2

1 Department of Internal Medicine and Systemic Diseases Santa Marta Hospital. University of Catania, Catania, Italy 2 General Surgery-Department of Surgical Sciences Organ Transplantation and Advanced Technologies University of Catania, Catania, Italy


Aim. Des-gamma-carboxy prothrombin (DCP) is an abnormal prothrombin, increased in serum of patients with hepatocellular carcinoma (HCC) as result of an acquired defect of post-translational carboxylation of prothrombin’s precursor. It is unclear if the reduced activity of gamma-carboxylase is secondary to vitamin K deficiency or to an altered gene encoding this enzyme. The aim of this study was to evaluate the effect of vitamin K administration on DCP and alpha-fetoprotein (AFP) levels, to identify a relationship between vitamin K and DCP serum levels and to investigate mechanisms of serum elevation of DCP levels.
Methods. The authors determined DCP and AFP serum levels and vitamin K concentration in 64 cirrhotics with HCC and in 60 cirrhotic subjects without HCC. In HCC subjects DCP and AFP levels were measured before and after vitamin K administration. A t-test for unpaired data was applied (P values <0.05 statistically significant).
Results. Only HCC patients had detectable levels of DCP and significant AFP levels. Administration of vitamin K reduced DCP but not AFP levels in HCC patients. No correlation was observed between vitamin K concentration and DCP levels: vitamin K concentration was similar both in HCC patients and in control group without HCC; HCC patients had the same vitamin K concentration regardless of elevated o reduced DCP levels after vitamin K administration.
Conclusion. DCP detectable serum levels are the result not only of vitamin K deficiency or selective defects of carboxylase, because probably alterations of membrane receptors or cytoplasmatic transfers, that are necessary for the function of vitamin K, are involved.

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