Expression of serum visfatin in 58 patients with hepatocellular carcinoma and its effects on long time survival

Abstract

Objective To explore the expression and significance of serum visfatin level in patients with hepatocellular carcinoma(HCC). Methods A total of 58 patients with primary HCC were collected. The gender, age and body mass index (BMI), matched healthy individuals were also collected. Serum were obtained for visfatin, pre-albumin and high sensitivity C-reaction protein (hs-CRP) detecting. Condition of nutrition was also evaluated. According to low, normal and high BMI (<18.5, 18.5 to 23.9, 24.0 to 27.9 kg/m2), patients with HCC were further divided. Non normal distribution of measurement data was indicated by median(interquartile range)[M(QR)]. Mann-Whitney U test and Kruskal-Wallis H test were performed for comparison between groups. Spearman correlation analysis was used for correlation analysis between visfatin and various factors. Cox regression analysis was used for analysis the risk factors of death. Results Serum visfatin level of HCC group was significantly higher than that of control group (127.65(200.66) μg/L vs 9.32(9.02) μg/L, U=-7.706, P<0.01). There was no significant difference in the visfatin level of HCC group between male and female patients (125.49(122.08) μg/L vs 133.64(212.20) μg/L, U=-1.432, P=0.152). Visfatin level of HCC group with low BMI, normal BMI and high BMI gradually increased (11.01(7.08) μg/L, 135.28(80.06) μg/L and 253.04(73.29) μg/L, H=42.034, P<0.01). There was no significant difference in serum visfatin between normal nutrition group and poor nutrition group of HCC patients (130.65(132.71) μg/L vs 118.76(160.30) μg/L, U=-0.960, P=0.337). Visfatin levels of HCC group with TNM stage Ⅰ to Ⅵ were 10.46(5.12) μg/L; 67.29(55.54) μg/L, 135.90(140.32) μg/L and 261.73(151.28) μg/L, respectively. Therein stage Ⅱ、Ⅲ and Ⅳ were significant highly than that of control group (U=-4.808、-7.221、-4.440, all P<0.01). When excluded form the effect of BMI, the increasing visfatin level was still correlated with TNM stage of HCC (r=0.735, P<0.01). In HCC group, the visfatin level was positively correlated with age, sex, BMI, waist/hip ratio, body fat content and hs-CRP (r=0.545, 0.133, 0.738, 0.495, 0.514 and 0.766, all P<0.05), and was negatively correlated with pre-albumin (r=-0.270, P=0.040). The mean follow-up time was 421 days, and 23 cases were dead. High serum visfatin level (relative risk (RR)=2.016, 95% confidence interval (CI) 1.159-2.932, P=0.002) and TNM stage (RR=2.181, 95%CI 1.342-3.674, P=0.001) were independent risk factors of patient death prediction. Conclusions The increasing serum visfatin level of HCC patients is correlated with nutrition status and TNM stage. High serum visfatin level is an independent risk factor of patient death prediction. Key words: Visfatin; Nutrition assessment; Liver neoplasms; Survival analysis