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Portal Vein Thrombosis and Markers of Inflammation in Hepatocellular Carcinoma

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Abstract

Background

Macroscopic portal vein thrombosis (PVT) is a major poor prognosis factor in patients with hepatocellular carcinoma (HCC). Inflammation is increasingly recognized to be part of the hepatocarcinogenic process and its markers are also prognostically useful.

Aims

To examine the relationship of inflammation biomarkers to the presence of PVT and to survival in PVT patients with HCC.

Methods

A large HCC cohort was examined for the presence of PVT and analyzed retrospectively.

Results

Blood levels of NLR, PLR, ESR, CRP, AFP and GGTP were significantly related to the presence of PVT, but not the Glasgow Index. For patients with low alpha-fetoprotein levels, blood ESR and GGTP levels were also significantly increased in patients with PVT compared with those in patients without PVT. In a Cox regression model, serum GGTP levels had a significantly increased hazard ratio on death (1.52, p = 0.008). Kaplan-Meier analysis showed that PVT patients with low serum GGTP levels had significantly longer survival than PVT patients with high GGTP levels (p = 0.0041).

Conclusions

Indices of inflammation, especially serum GGTP levels, related significantly to the presence of PVT and to survival in HCC patients with PVT.

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Abbreviations

HCC:

Hepatocellular carcinoma

PVT:

Portal vein thrombosis

AFP:

Alpha-fetoprotein

GGTP:

Gamma-glutamyl transpeptidase

CRP:

C-reactive protein

ESR:

Erythrocyte sedimentation rate

NLR:

Neutrophil to lymphocyte ratio

PLR:

Platelet to lymphocyte ratio

DCP:

Des-gamma-carboxy-prothrombin

MTD:

Maximum tumor diameter

CT:

Computerized axial tomography

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Funding

This work was supported in part by NIH grant CA 82723 (B.I.C).

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Authors and Affiliations

  1. Liver Transplant Institute, İnönü University, Bulgurlu Mah, Elazig Yolu 15 km, 44289 Merkez Battalgazi, Malatya, Turkey

    B.I. Carr

  2. National Institute of Gastroenterology, S. de Bellis Research Hospital, Bari, Italy

    V. Guerra & R. Donghia

Authors
  1. B.I. Carr
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  2. V. Guerra
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  3. R. Donghia
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Contributions

BIC: concept, ideas, and writing; VG, RD: statistics. All authors have read and agree with the contents of this paper.

Corresponding author

Correspondence to B.I. Carr.

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The authors declare that they have no conflict of interest.

Statement of Ethics

This work complies with the guidelines of the World Medical Association, Declaration of Helsinki. This work was approved by each institution’s IRB as documented in the “Methods” section.

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Carr, B., Guerra, V. & Donghia, R. Portal Vein Thrombosis and Markers of Inflammation in Hepatocellular Carcinoma. J Gastrointest Canc 51, 1141–1147 (2020). https://doi.org/10.1007/s12029-020-00489-7

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