Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences.
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, we measured serum FST in patients with liver diseases and assessed its clinical utility as a biomarker.
Serum was collected from 162 patients (91 hepatocellular carcinoma (HCC), 43 liver cirrhosis (LC), and 28 chronic hepatitis (CH)) as well as from 16 healthy volunteers. FST was quantified by enzyme-linked immunosorbent assays and levels compared with clinical parameters including survival of the HCC patients.
Median serum FST levels in HCC, LC, CH, 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, HCVAb-negativity, large tumor size, g-glutamyl transpeptidase(γ-GTP), des-gamma carboxyprothrombin(DCP) and presence of portal vein tumor thrombus (PVTT). 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 (HR=2.41, 95% CI=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.