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ISSN: 2329-6771

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Research Article

A Liver Index and its Relationship to Indices of HCC Aggressiveness

Brian I Carr1*, Vito Guerra2, Edoardo G Giannini3, Fabio Farinati4, Francesca Ciccarese5, Gian Ludovico Rapaccini6, Maria Di Marco7, Luisa Benvegnù8, Marco Zoli9, Franco Borzio10, Eugenio Caturelli11, Alberto Masotto12 and Franco Trevisani13

1Izmir Biomedicine and Genome Center, Dokuz Eylul University, Turkey and Lusaka Apex Medical University, Zambia

2Department of Clinical Trials and Epidemiology, IRCCS de Bellis, Castellana Grotte, Italy

3Department of Internal Medicine, Gastroenterology Unit, University of Genoa, Italy

4Department of Surgical Science and Gastroenterology, Gastroenterology Unit, University of Padua, Italy

5Division of Surgery, Policlinico San Marco, Zingonia, Italy

6Internal Medicine and Gastroenterology Unit, Catholic University of Rome, Italy

7Division of Medicine, Azienda Ospedaliera Bolognini, Seriate, Italy

8Department of Clinical and Experimental Medicine, Medical Unit, University of Padua, Italy

9Department of Medical and Surgical Science, Internal Medicine Unit, Alma Mater Studiorum, University of Bologna, Italy

10Department of Medicine, Internal Medicine and Hepatology Unit, Ospedale Fatebenefratelli, Milan, Italy

11Gastroenterology Unit, Ospedale Belcolle, Viterbo, Italy

12Gastroenterology Unit, Ospedale Sacro Cuore Don Calabria, Negrar, Italy

13Department of Medical Surgical Sciences, Medical Semiotics Unit, Alma Mater Studiorum, University of Bologna, Italy

Corresponding Author:
Brian I Carr, MD
Visiting Professor, Izmir Biomedicine and Genome Center
Dokuz Eylul University, Izmir, Turkey and Dean
Lusaka Apex Medical University, Lusaka, Zambia
Tel: 1 412 980 4518
E-mail: [email protected]

Received Date: August 01, 2016; Accepted Date: August 31, 2016; Published Date: September 05, 2016

Citation: Carr BI, Guerra V, Giannini EG, Farinati F, Ciccarese F, et al. (2016) A Liver Index and its Relationship to Indices of HCC Aggressiveness. J Integr Oncol 5:178. doi:10.4172/2329-6771.1000178

Copyright: © 2016 Carr BI 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.


A Hepatocellular (HCC) Aggressiveness Index was recently constructed, consisting of the sum of the scores for the 4 clinical parameters of maximum tumor size, multifocality, presence of portal vein thrombus and blood alphafetoprotein levels. It was observed that there was an association with several liver function tests. We have now formed a Liver Index from the 4 liver parameters with the highest hazard ratios with respect to HCC aggressiveness, namely: blood total bilirubin, gamma glutamyl transpeptidase (GGTP), albumin and platelet levels (cirrhosis surrogate). We found that the scores for the Liver Index related significantly to survival, but also to the Aggressiveness Index and to its individual HCC components as well as showing significant trends with the components. These results support the hypothesis that liver function is not only an important prognostic factor in HCC patients, but may also be involved in HCC biology and aggressiveness. Blood albumin, GGTP, albumin and platelet levels were used to create a Liver Index that related significantly to parameters of HCC aggressiveness.


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