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Reappraisal of the Role of Alkaline Phosphatase in Hepatocellular Carcinoma

Background: Alkaline phosphatase (ALP) is a marker of liver function and is associated with biliary tract disease. It was reported as a prognostic factor for hepatocellular carcinoma (HCC). The genetic expression in tumor-tissue microarrays and the perioperative serologic changes in ALP have never b...

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Autores principales: Huang, Chun-Wei, Wu, Tsung-Han, Hsu, Heng-Yuan, Pan, Kuang-Tse, Lee, Chao-Wei, Chong, Sio-Wai, Huang, Song-Fong, Lin, Sey-En, Yu, Ming-Chin, Chen, Shen-Ming
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9030712/
https://www.ncbi.nlm.nih.gov/pubmed/35455635
http://dx.doi.org/10.3390/jpm12040518
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author Huang, Chun-Wei
Wu, Tsung-Han
Hsu, Heng-Yuan
Pan, Kuang-Tse
Lee, Chao-Wei
Chong, Sio-Wai
Huang, Song-Fong
Lin, Sey-En
Yu, Ming-Chin
Chen, Shen-Ming
author_facet Huang, Chun-Wei
Wu, Tsung-Han
Hsu, Heng-Yuan
Pan, Kuang-Tse
Lee, Chao-Wei
Chong, Sio-Wai
Huang, Song-Fong
Lin, Sey-En
Yu, Ming-Chin
Chen, Shen-Ming
author_sort Huang, Chun-Wei
collection PubMed
description Background: Alkaline phosphatase (ALP) is a marker of liver function and is associated with biliary tract disease. It was reported as a prognostic factor for hepatocellular carcinoma (HCC). The genetic expression in tumor-tissue microarrays and the perioperative serologic changes in ALP have never been studied for their correlation with HCC prognosis. Methods: The genetic expression of ALP isoforms (placental (ALPP), intestinal (ALPI) and bone/kidney/liver (ALPL)) was analyzed in tumor and non-cancerous areas in 38 patients with HCC after partial hepatectomy. The perioperative change in ALP was further analyzed in a cohort containing 525 patients with HCC to correlate it with oncologic outcomes. A total of 43 HCC patients were enrolled for a volumetry study after major and minor hepatectomy. Results: The genetic expression of the bone/kidney/liver isoform was specifically and significantly higher in non-cancerous areas than in tumors. Patients with HCC with a higher ALP (>81 U/dL) had significantly more major hepatectomies, vascular invasion, and recurrence. Cox regression analysis showed that gender, major hepatectomies, the presence of satellite lesions, higher grades (III or IV) and perioperative changes in liver function tests were independent prognostic factors for recurrence-free survival, and a postoperative increase in the ALP ratio at postoperative day (POD) 7 vs. POD 0 > 1.46 should be emphasized. A liver regeneration rate more than 1.8 and correlation analysis revealed that the ALP level at POD 7 and 30 was significantly higher and correlated with remnant liver growth. Conclusions: This study demonstrated that the perioperative ALP change was an independent prognostic factor for HCC after partial hepatectomies, and the elevation of ALP represented a functional biomarker for the liver but not an HCC biomarker. The higher regeneration capacity was possibly associated with the elevation of ALP after operation.
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spelling pubmed-90307122022-04-23 Reappraisal of the Role of Alkaline Phosphatase in Hepatocellular Carcinoma Huang, Chun-Wei Wu, Tsung-Han Hsu, Heng-Yuan Pan, Kuang-Tse Lee, Chao-Wei Chong, Sio-Wai Huang, Song-Fong Lin, Sey-En Yu, Ming-Chin Chen, Shen-Ming J Pers Med Article Background: Alkaline phosphatase (ALP) is a marker of liver function and is associated with biliary tract disease. It was reported as a prognostic factor for hepatocellular carcinoma (HCC). The genetic expression in tumor-tissue microarrays and the perioperative serologic changes in ALP have never been studied for their correlation with HCC prognosis. Methods: The genetic expression of ALP isoforms (placental (ALPP), intestinal (ALPI) and bone/kidney/liver (ALPL)) was analyzed in tumor and non-cancerous areas in 38 patients with HCC after partial hepatectomy. The perioperative change in ALP was further analyzed in a cohort containing 525 patients with HCC to correlate it with oncologic outcomes. A total of 43 HCC patients were enrolled for a volumetry study after major and minor hepatectomy. Results: The genetic expression of the bone/kidney/liver isoform was specifically and significantly higher in non-cancerous areas than in tumors. Patients with HCC with a higher ALP (>81 U/dL) had significantly more major hepatectomies, vascular invasion, and recurrence. Cox regression analysis showed that gender, major hepatectomies, the presence of satellite lesions, higher grades (III or IV) and perioperative changes in liver function tests were independent prognostic factors for recurrence-free survival, and a postoperative increase in the ALP ratio at postoperative day (POD) 7 vs. POD 0 > 1.46 should be emphasized. A liver regeneration rate more than 1.8 and correlation analysis revealed that the ALP level at POD 7 and 30 was significantly higher and correlated with remnant liver growth. Conclusions: This study demonstrated that the perioperative ALP change was an independent prognostic factor for HCC after partial hepatectomies, and the elevation of ALP represented a functional biomarker for the liver but not an HCC biomarker. The higher regeneration capacity was possibly associated with the elevation of ALP after operation. MDPI 2022-03-23 /pmc/articles/PMC9030712/ /pubmed/35455635 http://dx.doi.org/10.3390/jpm12040518 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Huang, Chun-Wei
Wu, Tsung-Han
Hsu, Heng-Yuan
Pan, Kuang-Tse
Lee, Chao-Wei
Chong, Sio-Wai
Huang, Song-Fong
Lin, Sey-En
Yu, Ming-Chin
Chen, Shen-Ming
Reappraisal of the Role of Alkaline Phosphatase in Hepatocellular Carcinoma
title Reappraisal of the Role of Alkaline Phosphatase in Hepatocellular Carcinoma
title_full Reappraisal of the Role of Alkaline Phosphatase in Hepatocellular Carcinoma
title_fullStr Reappraisal of the Role of Alkaline Phosphatase in Hepatocellular Carcinoma
title_full_unstemmed Reappraisal of the Role of Alkaline Phosphatase in Hepatocellular Carcinoma
title_short Reappraisal of the Role of Alkaline Phosphatase in Hepatocellular Carcinoma
title_sort reappraisal of the role of alkaline phosphatase in hepatocellular carcinoma
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9030712/
https://www.ncbi.nlm.nih.gov/pubmed/35455635
http://dx.doi.org/10.3390/jpm12040518
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