Weiss Thomas S, Buechler Christa
Children's University Hospital (KUNO), Regensburg University Hospital, Regensburg, Germany.
Department of Internal Medicine I, Regensburg University Hospital, Regensburg, Germany
Anticancer Res. 2025 Mar;45(3):1171-1180. doi: 10.21873/anticanres.17504.
BACKGROUND/AIM: Serum proprotein convertase subtilisin/kexin type 9 (PCSK9) levels are positively associated with serum cholesterol levels, which contribute to the growth of cancers. PCSK9 levels are low in patients with liver cirrhosis, with a high incidence of hepatocellular carcinoma (HCC). PCSK9 expression is increased in colorectal cancer (CRC), but serum levels in these patients have not been analyzed. Therefore, serum PCSK9 may serve as a diagnostic marker to differentiate between liver metastases from CRC and HCC.
Serum PCSK9 was measured by ELISA in 36 patients with CRC metastases, 32 patients with HCC and 59 healthy controls.
The serum PCSK9 levels of these three cohorts were similar. Serum PCSK9 levels were not associated with the tumor node metastasis (TNM) stage. Liver steatosis, inflammation and fibrosis scores did not correlate with serum PCSK9 levels. Cancer patients with hypercholesterolemia had elevated PCSK9 levels. These patients had higher TNM stages and Union for International Cancer Control scores in both cohorts. PCSK9 levels were also elevated in patients with viral hepatitis. When patients with hepatitis and hypercholesterolemia were excluded, serum PCSK9 levels were low in cancer patients compared to controls. Serum PCSK9 levels did not correlate with the tumor markers carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) in HCC and CRC patients. In the latter cohort, PCSK9 and alpha-fetoprotein were positively correlated.
Serum PCSK9 is increased in patients with CRC metastases or HCC with hypercholesterolemia. This suggests that patients with high cholesterol levels may benefit most from PCSK9 blockage.
背景/目的：血清前蛋白转化酶枯草溶菌素9型（PCSK9）水平与血清胆固醇水平呈正相关，而血清胆固醇水平与癌症的发生发展有关。肝硬化患者的PCSK9水平较低，而肝细胞癌（HCC）的发病率较高。结直肠癌（CRC）患者的PCSK9表达增加，但尚未对这些患者的血清水平进行分析。因此，血清PCSK9可作为鉴别CRC肝转移和HCC的诊断标志物。
采用酶联免疫吸附测定法（ELISA）检测36例CRC转移患者、32例HCC患者和59例健康对照者的血清PCSK9水平。
这三组人群的血清PCSK9水平相似。血清PCSK9水平与肿瘤淋巴结转移（TNM）分期无关。肝脂肪变性、炎症和纤维化评分与血清PCSK9水平无关。高胆固醇血症癌症患者的PCSK9水平升高。这两组患者的TNM分期和国际癌症控制联盟评分更高。病毒性肝炎患者的PCSK9水平也升高。排除肝炎和高胆固醇血症患者后，癌症患者的血清PCSK9水平低于对照组。HCC和CRC患者的血清PCSK9水平与肿瘤标志物癌胚抗原（CEA）和糖类抗原19-9（CA19-9）无关。在CRC患者中，PCSK9与甲胎蛋白呈正相关。
CRC转移或HCC合并高胆固醇血症患者的血清PCSK9升高。这表明高胆固醇水平的患者可能从PCSK9阻断治疗中获益最大。
