TY  - JOUR
A1  - Finkelmeier, Fabian
A1  - Canli, Özge
A1  - Peiffer, Kai-Henrik
A1  - Walter, Dirk Henning
A1  - Tal, Andrea Oliver
A1  - Koch, Christine
A1  - Pession, Ursula
A1  - Vermehren, Johannes
A1  - Trojan, Jörg
A1  - Zeuzem, Stefan
A1  - Piiper, Albrecht
A1  - Greten, Florian
A1  - Grammatikos, Georgios
A1  - Waidmann, Oliver
T1  - Circulating hypoxia marker carbonic anhydrase IX (CA9) in patients with hepatocellular carcinoma and patients with cirrhosis
T2  - PLoS one
N2  - Background and aims: Expression of carbonic anhydrase IX (CA9), an enzyme expressed in response to hypoxia, acidosis and oncogenic alterations, is reported to be a prognostic factor in HCC patients. Here we evaluated serum CA9 levels in HCC and cirrhosis patients.
Methods: HCC and cirrhosis patients were prospectively recruited and CA9 levels were determined. CA9 levels were compared to stages of cirrhosis and HCC stages. The association of the CA9 levels and overall survival (OS) was assessed. Furthermore, immunohistochemical CA9 expression in HCC and cirrhosis was evaluated.
Results: 215 patients with HCC were included. The median serum CA9 concentration in patients with HCC was 370 pg/ml and significantly higher than in a healthy cohort. Patients with advanced cancer stages (BCLC and ALBI score) had hid significant higher levels of CA9 in the serum. HCC patients with high serum CA9 concentrations (>400 pg/ml) had an increased mortality risk (hazard ratio (HR) 1.690, 95% confidence interval (CI) 1.017–2.809, P = 0.043). Serum CA9 concentration in cirrhotic patients did not differ significantly from HCC patients. Higher CA9 levels in cirrhotic patients correlated with portal hypertension and esophageal varices. Patients with ethanol induced cirrhosis had the highest CA9 levels in both cohorts. Levels of CA9 did not correlate with immunohistochemical expression.
Conclusions: We conclude that a high CA9 level is a possible prognostic indicator for a poor outcome in HCC patients. The high CA9 levels are probably mainly associated with portal hypertension. Ductular reactions might be a possible source of serum CA9.
KW  - Cirrhosis
KW  - Hepatocellular carcinoma
KW  - Liver diseases
KW  - Infectious disease epidemiology
KW  - Membrane staining
KW  - Etiology
KW  - Portal hypertension
KW  - Negative staining
Y1  - 2018
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/33603
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-336031
SN  - 1932-6203
N1  - Copyright: © 2018 Finkelmeier et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
VL  - 13
IS  - (7): e0200855
SP  - 1
EP  - 16
PB  - PLoS
CY  - Lawrence, Kan.
ER  -