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Year : 2019  |  Volume : 31  |  Issue : 4  |  Page : 849-855

Prognostic value of serum autotaxin in liver cirrhosis and prediction of hepatocellular carcinoma

1 Department of Internal Medicine, Faculty of Medicine, Kasr Al-Ainy, Cairo University, Cairo, Egypt
2 Department of Biochemistry, Faculty of Medicine, Kasr Al-Ainy, Cairo University, Cairo, Egypt

Correspondence Address:
MD Nagwa Ramadan Ahmed
Faculty of Medicine, Cairo University, 9 Shannan Street-Mostafa Abd Razek-Abdeen, 11613
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ejim.ejim_63_19

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Background Autotaxin is a lysophospholipase D related to liver fibrosis; its clinical role in liver cirrhosis is still unknown or limited. In this study we investigate the relation of autotaxin serum levels and prognosis of liver disease and/or prediction of hepatocellular carcinoma (HCC) in hepatitis C virus (HCV) patients. Patients and methods This observational, prospective case–control study included 180 participants, 60 patients with HCV-related liver cirrhosis, 60 HCV noncirrhotic patients, and 60 healthy controls. They were enrolled from inpatients and clinics of a tertiary-care hospital. Baseline characteristics, serum autotaxin, Child–Turcotte–Pugh and model of end-stage liver disease scores were determined. Abdominal ultrasound and upper gastrointestinal endoscopy were done at the beginning of the study. Cirrhotic patients were prospectively followed up for 6 months. Results Patients with liver cirrhosis had the highest level of autotaxin (106±24 μg/ml) compared with noncirrhotic HCV patients (81.9±21 μg/ml) and healthy controls (42.5±11 μg/ml) using one-way analysis of variance test (P=0.000). Spearman’s correlation analysis showed no significant correlation between autotaxin and Child–Turcotte–Pugh score (r=0.02; P<0.70), and model of end-stage liver disease score (r=0.15; P<0.41). At 6 months of follow-up, patients who developed HCC or encephalopathy had significantly higher baseline autotaxin level (141±55 μg/ml; P=0.02, 117±56.6 μg/ml; P=0.000), respectively, than patients who did not (102±34, 90.7±40 μg/ml). Cutoff values of autotaxin for the prediction of HCC and encephalopathy were 95 and 92 μg/ml, respectively, with 91 and 92% sensitivity. Conclusion Autotaxin is a sensitive predictor for the development of HCC and encephalopathy in HCV-related cirrhotic patients. However, it was not related to disease severity.

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