Clinical significance of serum transthyretin level in patients with hepatocellular carcinoma.

BACKGROUND: Although serum albumin has been reported to be useful as a prognostic biomarker for various malignancies, it is not suitable for prognosis of patients with hepatocellular carcinoma (HCC) due to impaired liver function. We aimed to determine whether serum transthyretin (TTR) level can be used as a novel prognostic biomarker.

METHODS: Serum levels of TTR, as well as other nutritional and inflammatory parameters including angiogenic factors, were examined in 25 patients with HCC.

RESULTS: The serum TTR levels exhibited a statistically significant inverse correlation with interleukin-6 (r = -0.412, P = 0.041), and showed statistically significant correlations with retinol-binding protein (r = 0.919, P < 0.001) and albumin (r = 0.442, P = 0.027). The patients with TTR <11.4 mg/dL (P = 0.012), those with ≥T2 (P = 0.011) and those with a retention rate of indocyanine green after 15 min ≥15.5 (P = 0.037) showed poorer prognoses than the counterparts of each parameter. The TTR level <11.4 mg/dL (hazard ratio: 4.837, 95% confidence interval: 1.118-20.926, P = 0.035) and ≥T2 (hazard ratio: 5.011, 95% confidence interval: 1.243-20.203, P = 0.023) were independent prognostic factors of HCC patients.

CONCLUSION: Serum TTR measurement can be useful for predicting the prognosis of patients with HCC.