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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MDPI AG
2022-03-01
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| Series: | Journal of Personalized Medicine |
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| Online Access: | https://www.mdpi.com/2075-4426/12/4/518 |
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| author | Chun-Wei Huang Tsung-Han Wu Heng-Yuan Hsu Kuang-Tse Pan Chao-Wei Lee Sio-Wai Chong Song-Fong Huang Sey-En Lin Ming-Chin Yu Shen-Ming Chen |
| author_facet | Chun-Wei Huang Tsung-Han Wu Heng-Yuan Hsu Kuang-Tse Pan Chao-Wei Lee Sio-Wai Chong Song-Fong Huang Sey-En Lin Ming-Chin Yu Shen-Ming Chen |
| author_sort | Chun-Wei Huang |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-03-09T13:27:16Z |
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| institution | Directory Open Access Journal |
| issn | 2075-4426 |
| language | English |
| last_indexed | 2024-03-09T13:27:16Z |
| publishDate | 2022-03-01 |
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| record_format | Article |
| series | Journal of Personalized Medicine |
| spelling | doaj.art-67e4d5dcf5654595985825223ab7f7cc2023-11-30T21:22:24ZengMDPI AGJournal of Personalized Medicine2075-44262022-03-0112451810.3390/jpm12040518Reappraisal of the Role of Alkaline Phosphatase in Hepatocellular CarcinomaChun-Wei Huang0Tsung-Han Wu1Heng-Yuan Hsu2Kuang-Tse Pan3Chao-Wei Lee4Sio-Wai Chong5Song-Fong Huang6Sey-En Lin7Ming-Chin Yu8Shen-Ming Chen9Division of General Surgery, Department of Surgery, New Taipei Municipal Tucheng Hospital (by Chang Gung Medical Foundation, and Chang Gung University and Shen-Ming Chen), New Taipei 23652, TaiwanDepartment of Surgery, Chang Gung Memorial Hospital, Linkou and Chang-Gung University, Taoyuan 33305, TaiwanDivision of General Surgery, Department of Surgery, New Taipei Municipal Tucheng Hospital (by Chang Gung Medical Foundation, and Chang Gung University and Shen-Ming Chen), New Taipei 23652, TaiwanDepartment of Medical Imaging and Intervention, Linkou Chang Gung Memorial Hospital, Taoyuan 33305, TaiwanDepartment of Surgery, Chang Gung Memorial Hospital, Linkou and Chang-Gung University, Taoyuan 33305, TaiwanDivision of General Surgery, Department of Surgery, New Taipei Municipal Tucheng Hospital (by Chang Gung Medical Foundation, and Chang Gung University and Shen-Ming Chen), New Taipei 23652, TaiwanDivision of General Surgery, Department of Surgery, New Taipei Municipal Tucheng Hospital (by Chang Gung Medical Foundation, and Chang Gung University and Shen-Ming Chen), New Taipei 23652, TaiwanDepartment of Pathology, New Taipei Municipal Tucheng Hospital, New Taipei 23652, TaiwanDivision of General Surgery, Department of Surgery, New Taipei Municipal Tucheng Hospital (by Chang Gung Medical Foundation, and Chang Gung University and Shen-Ming Chen), New Taipei 23652, TaiwanDepartment of Chemical Engineering and Biotechnology, National Taipei University of Technology, Taipei 106, TaiwanBackground: 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.https://www.mdpi.com/2075-4426/12/4/518hepatocellular carcinomaalkaline phosphataseliver regeneration |
| spellingShingle | Chun-Wei Huang Tsung-Han Wu Heng-Yuan Hsu Kuang-Tse Pan Chao-Wei Lee Sio-Wai Chong Song-Fong Huang Sey-En Lin Ming-Chin Yu Shen-Ming Chen Reappraisal of the Role of Alkaline Phosphatase in Hepatocellular Carcinoma Journal of Personalized Medicine hepatocellular carcinoma alkaline phosphatase liver regeneration |
| 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 | hepatocellular carcinoma alkaline phosphatase liver regeneration |
| url | https://www.mdpi.com/2075-4426/12/4/518 |
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