Hepatocyte growth factor and the risk of pulmonary embolism

Abstract

BackgroundDiagnosis of pulmonary embolism (PE) in early stages by conventional laboratory methods is difficult because the currently available tests lack sufficient sensitivity and specificity. Hepatocyte growth factor (HGF) was originally regarded as specific to hepatocytes, but has been found to be identical to the scatter factor affecting a wide range of tissues including the lungs.The aim of this work is to study the relationship between HGF and PE. Patients and methodsThis study included 40 patients with PE, 40 stable angina (SA) patients, and 10 healthy controls. HGF and d-dimer were measured in all patients of this study. ResultsMean HGF was significantly higher in the PE group (788.8±361.5pg/ml) compared to the SA group (262.4±158.1pg/ml) and control group (215.5±18.5pg/ml) (P=0.0001). The predictive values of d-dimer in the diagnosis of PE were as follows: 100% sensitivity and negative predictive value, 80% specificity, 83.3% positive predictive value and 90% accuracy, while those of HGF were: 97.5% sensitivity, 97.4% negative predictive value, 92.5% specificity, 92.9% positive predictive value and 95% accuracy. When used both d-dimer and HGF together the values improved to: 100% sensitivity and negative predictive value, 97.5% specificity, 97.6% positive predictive value and 98.8% accuracy. ConclusionsOur observations suggest that the plasma HGF level may be a useful biological marker of pulmonary ischemia, and a valuable tool for early diagnosis of PE. Clarification of the mechanisms, characteristics, and biological significance of HGF elevation is important for clinical use in diagnosing and treating pulmonary ischemia. The use of both d-dimer and HGF increases the predictive power of both tests when used together. The clinical significance of the role of HGF in PE opens a new therapeutic area in treating acute ischemic pulmonary disease that would be able to prolong the time frame for the application of reperfusion–thrombolytic therapy.