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Prognostic Value of Serum Caspase-Cleaved Cytokeratin-18 Levels before Liver Transplantation for One-Year Survival of Patients with Hepatocellular Carcinoma

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Intensive Care Unit, Hospital Universitario de Canarias, Ofra, s/n. La Laguna, Tenerife 38320, Spain
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Intensive Care Unit, Hospital Universitario Nuestra Señora Candelaria, Crta Rosario s/n, Santa Cruz Tenerife 38010, Spain
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Deparment of Surgery, Hospital Universitario Nuestra Señora de Candelaria, Crta Rosario s/n, Santa Cruz Tenerife 38010, Spain
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Laboratory Deparment, Hospital Universitario de Canarias, Ofra, s/n. La Laguna, Tenerife 38320, Spain
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Deparment of Digestive, Hospital Universitario Nuestra Señora de Candelaria, Crta Rosario s/n, Santa Cruz Tenerife 38010, Spain
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Research Unit, Hospital Universitario de Canarias, Ofra, s/n. La Laguna, Tenerife 38320, Spain
*
Author to whom correspondence should be addressed.
Academic Editor: Amedeo Lonardo
Int. J. Mol. Sci. 2016, 17(9), 1524; https://doi.org/10.3390/ijms17091524
Received: 8 June 2016 / Revised: 1 September 2016 / Accepted: 5 September 2016 / Published: 9 September 2016
(This article belongs to the Section Molecular Pathology, Diagnostics, and Therapeutics)
Cytokeratin (CK)-18 is the major intermediate filament protein in the liver and during hepatocyte apoptosis is cleaved by the action of caspases; the resulting fragments are released into the blood as caspase-cleaved cytokeratin (CCCK)-18. Higher circulating levels of CCCK-18 have been found in patients with hepatocellular carcinoma (HCC) than in healthy controls and than in cirrhotic patients. However, it is unknown whether serum CCCK-18 levels before liver transplantation (LT) in patients with HCC could be used as a prognostic biomarker of one-year survival, and this was the objective of our study with 135 patients. At one year after LT, non-survivors showed higher serum CCCK-18 levels than survivors (p = 0.001). On binary logistic regression analysis, serum CCCK-18 levels >384 U/L were associated with death at one year (odds ratio = 19.801; 95% confidence interval = 5.301–73.972; p < 0.001) after controlling for deceased donor age. The area under the receiver operating characteristic (ROC) curve of serum CCCK-18 levels to predict death at one year was 77% (95% CI = 69%–84%; p < 0.001). The new finding of our study was that serum levels of CCCK-18 before LT in patients with HCC could be used as prognostic biomarker of survival. View Full-Text
Keywords: cytokeratin; hepatocellular carcinoma; liver transplantation; mortality; outcome cytokeratin; hepatocellular carcinoma; liver transplantation; mortality; outcome
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Lorente, L.; Rodriguez, S.T.; Sanz, P.; Pérez-Cejas, A.; Padilla, J.; Díaz, D.; González, A.; Martín, M.M.; Jiménez, A.; Barrera, M.A. Prognostic Value of Serum Caspase-Cleaved Cytokeratin-18 Levels before Liver Transplantation for One-Year Survival of Patients with Hepatocellular Carcinoma. Int. J. Mol. Sci. 2016, 17, 1524.

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