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Panminerva Medica 2017 December;59(4):283-9

DOI: 10.23736/S0031-0808.17.03353-5


lingua: Inglese

Risk of hepatocellular carcinoma in HBV cirrhotic patients assessed by the combination of miR-122, AFP and PIVKA-II

Gian P. CAVIGLIA 1 , Maria L. ABATE 1, Silvia GAIA 2, Elisa PETRINI 2, Caterina BOSCO 1, Antonella OLIVERO 1, Chiara ROSSO 1, Alessia CIANCIO 1, 2, Rinaldo PELLICANO 2, Giorgio M. SARACCO 1, 2, Mario RIZZETTO 1, 2, Antonina SMEDILE 1, 2

1 Department of Medical Sciences, University of Turin, Turin, Italy; 2 Department of Gastroenterology and Hepatology, Città della Salute e della Scienza, Molinette Hospital, Turin, Italy


BACKGROUND: Reliable biomarkers for early detection of hepatocellular carcinoma (HCC) in patients with cirrhosis are lacking. We evaluated the use of miR-122, alpha-fetoprotein (AFP) and protein induced by vitamin k absence/antagonist II (PIVKA-II) for HCC risk prediction in patients with HBV-related cirrhosis under surveillance.
METHODS: We first analyzed a group of 63 patients with HBV-related liver cirrhosis of whom 33 had HCC. Then we performed a retrospective analysis on another group of 13 cirrhotic patients who developed HCC during surveillance, of whom serial serum samples were available (at time of HCC diagnosis [T0], 6-9 months [T-1] and 12-18 months [T-2] before HCC detection). Serum miR-122 levels were assessed by quantitative real time-PCR, whereas AFP and PIVKA-II were measured by fully automated chemiluminescent enzyme immunoassay.
RESULTS: Serum levels of miR-122, AFP and PIVKA-II were different between patients with cirrhosis and those with HCC (P=0.024, P<0.001 and P<0.001, respectively). Areas under the curve (AUC) were 0.675 for miR-122, 0.791 for AFP and 0.846 for PIVKA-II, while their combination improved the discrimination power between cirrhosis and HCC (AUC=0.918). In the longitudinal study, we found a significant variation overtime for the biomarkers combination (P=0.011) but not for each single biomarker (miR-122, P=0.163; AFP, P=0.170; PIVKA-II, P=0.447). Combined miR-122+AFP+PIVKA-II adjusted Hazard Ratio for HCC development was 10.63, 95% confidence interval 1.87-60.28 (P<0.001).
CONCLUSIONS: In HBV-related cirrhosis, the combination of miR-122, AFP and PIVKA-II enables the identification of patients at higher risk of HCC development that could benefit from closer monitoring.

KEY WORDS: Alpha-fetoproteins - Carcinoma, hepatocellular - MicroRNAs

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