Conflict of interests: There is no conflict of interest.
Prognotic impact of serum follistatin in patients with hepatocellular carcinoma
Article first published online: 22 JUL 2013
© 2013 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd
Journal of Gastroenterology and Hepatology
Volume 28, Issue 8, pages 1391–1396, August 2013
How to Cite
Tomoda, T., Nouso, K., Miyahara, K., Kobayashi, S., Kinugasa, H., Toyosawa, J., Hagihara, H., Kuwaki, K., Onishi, H., Nakamura, S., Ikeda, F., Miyake, Y., Shiraha, H., Takaki, A. and Yamamoto, K. (2013), Prognotic impact of serum follistatin in patients with hepatocellular carcinoma. Journal of Gastroenterology and Hepatology, 28: 1391–1396. doi: 10.1111/jgh.12167
Financial support: This work was supported by a Grant-in-Aid for Scientific Research from the Japan Society for the Promotion of Science (KAKENHI 23590976).
- Issue published online: 22 JUL 2013
- Article first published online: 22 JUL 2013
- Accepted manuscript online: 22 FEB 2013 10:03AM EST
- Manuscript Accepted: 4 FEB 2013
- Japan Society for the Promotion of Science. Grant Number: KAKENHI 23590976
Background and Aim
Follistatin (FST) is a glycoprotein expressed in most organs, which interacts with activins or other members of the transforming growth factor beta family. Recently, several reports have shown that FST regulates a variety of processes during tumor progression. Here, serum FST in patients with liver diseases was measured, and its clinical utility as a biomarker was assessed.
Serum was collected from 162 patients (91 hepatocellular carcinoma [HCC], 43 liver cirrhosis, and 28 chronic hepatitis) as well as from 16 healthy volunteers. FST was quantified by enzyme-linked immunosorbent assays, and levels were compared with clinical parameters including survival of the HCC patients.
Median serum FST levels in HCC, liver cirrhosis, chronic hepatitis, and healthy volunteers were 1168, 1606, 1324, and 1661 pg/mL, respectively, not significantly different. In HCC patients, higher serum FST was associated with greater age, hepatitis C virus antibody-negativity, large tumor size, g-glutamyl transpeptidase, des-gamma carboxyprothrombin and presence of portal vein tumor thrombus. Survival of HCC patients with high FST levels was significantly shorter than for those with low levels (P = 0.004). Multivariate analysis revealed that in addition to large tumor size and presence of portal vein thrombus, high FST levels were independently correlated with poor prognosis (hazard ratio = 2.41, 95% confidence interval = 1.16–5.00, P = 0.02).
Serum FST levels are significantly associated with HCC prognosis and could represent a predictive biomarker in this disease.