Plasma level of vitamin K-dependent clotting factors as marker for hepatocellular carcinoma (original) (raw)

1991, Journal of Hepatology

Hepatocellular carcinoma (HCC). the most common type of primary liver cancer. mainly affects patients with cirrh& Early detection of HCC is of obvious interest (1) and is based on liver ultrasonography and serological markers such as ufetoprotein (AFP) (2) and dercarboxyprotbrombi" (DCP) (3). In a "on-negligible proportion of HCC patients. however, a" increase in either of these markers is lacknng, especially in patients with small tumors. In the pwent study we measured the plasma levels of vitamin K-dependent clotting factors (factors II. "II. IX and X). together Gth sarotugical markers of HCC. in 56 cirrhotic patients with hwotogieslly with negative factor II criteria and thorc with podiw factor II criteria. This indicates that the factor ,I de:rrase observed in patients with HCC evolved wid, n mccbamxa independent of the mechanism for DCP synthesis. In c~rrbolic pnticntn with HCC the decrease in factor I, and factor IX might be related to a defect in a common rcg",ation process, which surprisingly does not affect a,, vitamin K-dqcndent far!ors and 1s r&ted to the presence of mnbpnant hepafocytes. We believe that poririvc factor II crifcna const~t"tes a specific complementary tumor marker for HCC. and may aid in detecting malignant transformation in cirrhosis OI chronic hzpatifis. Though i,s capacity for early diagnosis needs to be dctcrmined with B prospective study, this capacity seems possible to infer since in the few cases with extendrd *o,,aw-up, positive factor I, crifern appeared largely befoie the discovery of positive AFP. It m"st be emphasized that meas"remenf of 'prolhrombin complex' (factors II, VII + X, and V) constitutes an inexpensive and simple laboratory lest, umhich can be performed in most laboratoriea to screen high nsk groups at regular intervals. Moreover. measurement cf L!lese coagulation factors is usually included in the monitoring of patients with hepntic diseases.