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Öğe C-Reactive Protein and Platelet-Lymphocyte Ratio as Potential Tumor Markers in Low-Alpha-Fetoprotein Hepatocellular Carcinoma(Karger, 2019) Suner, Asli; Carr, Brian I.; Akkiz, Hikmet; Karakulah, Gokhan; Uskudar, Oguz; Yalcin, Kendal; Kuran, SedefThe hepatocellular carcinoma (HCC) tumor marker alpha-fetoprotein (AFP) is only elevated in about half of the HCC patients, limiting its usefulness in following the effects of therapy or screening. New markers are needed. It has been previously noted that the inflammation markers C-reactive protein (CRP) and platelet-lymphocyte ratio (PLR) are prognostically important and may reflect HCC aggressiveness. We therefore examined these 2 markers in a low-AFP HCC cohort and found that for HCCs > 2 cm, both markers significantly rise with an increasing maximum tumor diameter (MTD). We calculated the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and Youden index value for each marker, and their area-under-the-curve values for each MTD group. Patients were dichotomized into 2 groups based on the CRP and PLR from the receiver-operating characteristic curve analysis. In the logistic regression models of the 4 different MTD patient groups, CRP and PLR levels were statistically significant to estimate MTD in univariate logistic regression models of MTD groups > 2 cm. CRP and PLR were then combined, and the combination was statistically significant to estimate MTD groups of 3-, 4-, and 5-cm cutoffs. CRP and PLR thus have potential as tumor markers for low-AFP HCC patients, and possibly for screening. (C) 2018 S. Karger AG, BaselÖğe HBsAg relapse after living donor liver transplantation in hepatocelluler carcinoma patients with hepatitis D virus infection may result in hepatocellular carcinoma relapse(Elsevier, 2020) Baskiran, Adil; Sahin, Tevfik Tolga; Ince, Volkan; Karakas, Serdar; Ozdemir, Fatih; Cicek, Ipek Balikci; Yalcin, Kendal[Abstract Not Available]Öğe Serum levels of inflammatory markers CRP, ESR and albumin in relation to survival for patients with hepatocellular carcinoma(Wiley, 2021) Akkiz, Hikmet; Carr, Brian I.; Bag, Harika G.; Karaogullarindan, Umit; Yalcin, Kendal; Ekin, Nazim; Ozakyol, AysegulIntroduction Hepatocellular carcinoma is associated with several chronic inflammatory conditions. It is increasingly understood that the inflammation may be part of the carcinogenic process and prognostically important. Objective To evaluate the serum levels of three inflammation markers in relation to survival in HCC patients. Methods We retrospectively examined the serum levels of CRP, albumin and ESR, both singly and in combination, in relation to patient survival. Results Survival worsened with increase in CRP or ESR or decrease in albumin levels. Combinations of CRP plus albumin or CRP plus ESR were associated with an even greater range of survival (3-fold), together with significant differences in maximum tumor diameter (PVT) and percent of patients with portal vein thrombosis (PVT). The triplet of CRP plus albumin plus ESR was associated with a sevenfold difference in survival, comparing low vs high parameter levels. These significant differences were found in patients with small or large tumors. Conclusions Combinations of CRP with albumin or ESR or all three parameters together significantly related to differences in survival and to differences in MTD and percent PVT, in patients with both small and large size HCCs.