1. Department of Hepatology, Kanazawa Medical University, Uchinada, Ishikawa, Japan;
2. Department of Gastroenterology, Kanazawa Medical University, Uchinada, Ishikawa, Japan.
J Cancer. 2014 Mar 4;5(3):221-30. doi: 10.7150/jca.7691. eCollection 2014.
Endocan is a vascular endothelium-derived factor regulated by angiogenic factors. The aim of this study was to determine whether serum endocan levels are prognostic for survival in patients with hepatocellular carcinoma (HCC). Serum endocan levels were measured in 64 HCC patients who were naïve to treatment, eight apparently healthy subjects, and 68 patients with liver cirrhosis; the latter two groups served as controls. Prognostic factors for the survival of HCC patients were examined using a Cox proportional hazards model. The median serum endocan levels were 1.145 ng/mL (range, 0.93-1.68 ng/mL) in healthy subjects, 1.93 ng/mL (range, 0.45-8.47 ng/mL) in liver cirrhosis patients, and 3.73 ng/mL (range, 0.74-10.95 ng/mL) in HCC patients (P = 0.0001). In HCC patients, elevated serum endocan levels were significantly associated with poor hepatic function (P = 0.015), a greater number of tumors (P = 0.034), and vascular invasion (P = 0.043). The median follow-up period was 23.0 months, and 33 HCC patients died during follow up. Multivariate analysis showed that serum endocan levels ≥ 2.20 ng/mL (hazard ratio 2.36, 95% confidence interval 1.22-5.36, P = 0.008) as well as elevated serum α-fetoprotein and des-γ-carboxy prothrombin levels were independent prognostic biomarkers for poor survival. The combination of serum endocan and these two additional markers was significantly predictive of worse survival (P < 0.0001). Thus, serum endocan may be a prognostic biomarker for survival in HCC patients, and the combination of serum endocan, α-fetoprotein, and des-γ-carboxy prothrombin levels can result in better prognostic stratification of these patients.
内皮细胞来源的内克蛋白是一种血管内皮细胞衍生的因子，受血管生成因子调节。本研究旨在确定血清内克蛋白水平是否与肝细胞癌（HCC）患者的生存相关。对 64 例未经治疗的 HCC 患者、8 例健康对照者和 68 例肝硬化患者进行了血清内克蛋白水平测定，后两组为对照组。采用 Cox 比例风险模型对 HCC 患者的生存预后因素进行了分析。健康对照者的血清内克蛋白水平中位数为 1.145ng/ml（范围 0.93-1.68ng/ml），肝硬化患者为 1.93ng/ml（范围 0.45-8.47ng/ml），HCC 患者为 3.73ng/ml（范围 0.74-10.95ng/ml）（P=0.0001）。在 HCC 患者中，血清内克蛋白水平升高与肝功能较差（P=0.015）、肿瘤数目较多（P=0.034）和血管侵犯（P=0.043）显著相关。中位随访时间为 23.0 个月，33 例 HCC 患者在随访期间死亡。多变量分析显示，血清内克蛋白水平≥2.20ng/ml（风险比 2.36，95%置信区间 1.22-5.36，P=0.008）以及血清 α-胎蛋白和去羧基凝血酶原水平升高是不良生存的独立预后生物标志物。血清内克蛋白与这两个附加标志物的联合显著预测了更差的生存（P<0.0001）。因此，血清内克蛋白可能是 HCC 患者生存的预后生物标志物，血清内克蛋白、α-胎蛋白和去羧基凝血酶原水平的联合可更好地对这些患者进行预后分层。
