Portal Vein Thrombosis and Markers of Inflammation in Hepatocellular Carcinoma

Abstract

Background: Macroscopic portal vein thrombosis (PVT) is a major poor prognosis factor in patients with hepatocellular carcinoma (HCC). Inflammation is increasingly recognized to be part of the hepatocarcinogenic process and its markers are also prognostically useful.

Aims: To examine the relationship of inflammation biomarkers to the presence of PVT and to survival in PVT patients with HCC.

Methods: A large HCC cohort was examined for the presence of PVT and analyzed retrospectively.

Results: Blood levels of NLR, PLR, ESR, CRP, AFP and GGTP were significantly related to the presence of PVT, but not the Glasgow Index. For patients with low alpha-fetoprotein levels, blood ESR and GGTP levels were also significantly increased in patients with PVT compared with those in patients without PVT. In a Cox regression model, serum GGTP levels had a significantly increased hazard ratio on death (1.52, p = 0.008). Kaplan-Meier analysis showed that PVT patients with low serum GGTP levels had significantly longer survival than PVT patients with high GGTP levels (p = 0.0041).

Conclusions: Indices of inflammation, especially serum GGTP levels, related significantly to the presence of PVT and to survival in HCC patients with PVT.

Keywords: ESR; HCC; NLR; PLR; PVT; Survival.