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1. Pattern of macrovascular invasion in hepatocellular carcinoma

Author

Guarino, M., Cucchetti, A., Pontillo, G., Farinati, F., Benevento, F., Rapaccini, G. L., Di Marco, M., Caturelli, E., Zoli, M., Rodolfo, S., Cabibbo, G., Marra, F., Mega, A., Gasbarrini, A., Svegliati-Baroni, G., Foschi, F. G., Missale, G., Masotto, A., Nardone, G., Raimondo, G., Azzaroli, F., Vidili, G., Oliveri, F., Trevisani, F., Giannini, E. G., Morisco, F., Biselli, M., Caraceni, P., Garuti, F., Gramenzi, A., Neri, A., Rampoldi, D., Santi, V., Forgione, A., Granito, A., Muratori, L., Piscaglia, F., Sansone, V., Tovoli, F., Dajti, E., Marasco, G., Ravaioli, F., Cappelli, A., Golfieri, R., Mosconi, C., Renzulli, M., Cela, E. M., Facciorusso, A., Pelizzaro, F., Imondi, A., Sartori, A., Penzo, B., Cacciato, V., Casagrande, E., Moscatelli, A., Pellegatta, G., Pieri, G., de Matthaeis, N., Allegrini, G., Lauria, V., Ghittoni, G., Pelecca, G., Chegai, F., Coratella, F., Ortenzi, M., Olivari, A., Inno, A., Marchetti, F., Busacca, A., Camma, C., Di Martino, V., Rizzo, G. E. M., Franze, M. S., Saitta, C., Sauchella, A., Bevilacqua, V., Borghi, A., Gardini, A. C., Conti, F., Berardinelli, D., Ercolani, G., Napoli, L., Campani, C., Di Bonaventura, C., Gitto, S., Coccoli, P., Malerba, A., Capasso, M., Fiorentino, A., Pignata, L., Cossiga, V., Romagnoli, V., Guarino M., Cucchetti A., Pontillo G., Farinati F., Benevento F., Rapaccini G.L., Di Marco M., Caturelli E., Zoli M., Rodolfo S., Cabibbo G., Marra F., Mega A., Gasbarrini A., Svegliati-Baroni G., Foschi F.G., Missale G., Masotto A., Nardone G., Raimondo G., Azzaroli F., Vidili G., Oliveri F., Trevisani F., Giannini E.G., Morisco F., Biselli M., Caraceni P., Garuti F., Gramenzi A., Neri A., Rampoldi D., Santi V., Forgione A., Granito A., Muratori L., Piscaglia F., Sansone V., Tovoli F., Dajti E., Marasco G., Ravaioli F., Cappelli A., Golfieri R., Mosconi C., Renzulli M., Cela E.M., Facciorusso A., Pelizzaro F., Imondi A., Sartori A., Penzo B., Cacciato V., Casagrande E., Moscatelli A., Pellegatta G., Pieri G., de Matthaeis N., Allegrini G., Lauria V., Ghittoni G., Pelecca G., Chegai F., Coratella F., Ortenzi M., Olivari A., Inno A., Marchetti F., Busacca A., Camma C., Di Martino V., Rizzo G.E.M., Franze M.S., Saitta C., Sauchella A., Bevilacqua V., Borghi A., Gardini A.C., Conti F., Berardinelli D., Ercolani G., Napoli L., Campani C., Di Bonaventura C., Gitto S., Coccoli P., Malerba A., Capasso M., Fiorentino A., Pignata L., Cossiga V., Romagnoli V., Guarino, M., Cucchetti, A., Pontillo, G., Farinati, F., Benevento, F., Rapaccini, G. L., Di Marco, M., Caturelli, E., Zoli, M., Rodolfo, S., Cabibbo, G., Marra, F., Mega, A., Gasbarrini, A., Svegliati-Baroni, G., Foschi, F. G., Missale, G., Masotto, A., Nardone, G., Raimondo, G., Azzaroli, F., Vidili, G., Oliveri, F., Trevisani, F., Giannini, E. G., Morisco, F., Biselli, M., Caraceni, P., Garuti, F., Gramenzi, A., Neri, A., Rampoldi, D., Santi, V., Forgione, A., Granito, A., Muratori, L., Piscaglia, F., Sansone, V., Tovoli, F., Dajti, E., Marasco, G., Ravaioli, F., Cappelli, A., Golfieri, R., Mosconi, C., Renzulli, M., Cela, E. M., Facciorusso, A., Pelizzaro, F., Imondi, A., Sartori, A., Penzo, B., Cacciato, V., Casagrande, E., Moscatelli, A., Pellegatta, G., Pieri, G., de Matthaeis, N., Allegrini, G., Lauria, V., Ghittoni, G., Pelecca, G., Chegai, F., Coratella, F., Ortenzi, M., Olivari, A., Inno, A., Marchetti, F., Busacca, A., Camma, C., Di Martino, V., Rizzo, G. E. M., Franze, M. S., Saitta, C., Sauchella, A., Bevilacqua, V., Borghi, A., Gardini, A. C., Conti, F., Berardinelli, D., Ercolani, G., Napoli, L., Campani, C., Di Bonaventura, C., Gitto, S., Coccoli, P., Malerba, A., Capasso, M., Fiorentino, A., Pignata, L., Cossiga, V., and Romagnoli, V.

Subjects
Ablation Techniques, Male, Registrie, Cirrhosis, Clinical Biochemistry, Mesenteric Vein, loco-regional treatment, 030204 cardiovascular system & hematology, Biochemistry, Gastroenterology, surgery, Antineoplastic Agent, Liver disease, 0302 clinical medicine, Non-alcoholic Fatty Liver Disease, cirrhosis, hepatocellular carcinoma, portal vein thrombosis, transplantation, Ascites, Ablation Technique, Registries, 030212 general & internal medicine, Chronic, Settore MED/12 - Gastroenterologia, Portal Vein, Liver Diseases, Liver Neoplasms, General Medicine, Middle Aged, Sorafenib, Prognosis, Hepatitis B, Alcoholic, Hepatitis C, Tumor Burden, Survival Rate, Italy, Liver Neoplasm, Hepatocellular carcinoma, Ascite, Female, medicine.symptom, Liver cancer, Human, medicine.medical_specialty, Carcinoma, Hepatocellular, Prognosi, Antineoplastic Agents, End Stage Liver Disease, 03 medical and health sciences, Mesenteric Veins, Hepatitis B, Chronic, Internal medicine, medicine, Humans, Hepatectomy, Neoplasm Invasiveness, portal vein thrombosi, Liver Diseases, Alcoholic, Aged, Neoplasm Invasivene, Performance status, business.industry, Carcinoma, Settore MED/09 - MEDICINA INTERNA, Patient Acuity, Hepatocellular, Hepatitis C, Chronic, medicine.disease, Liver Transplantation, Transplantation, Liver function, business, cirrhosi
Abstract

Background and aims: In patients with hepatocellular carcinoma (HCC), macrovascular invasion (MaVI) limits treatment options and decreases survival. Detailed data on the relationship between MaVI extension and patients' characteristics, and its impact on patients' outcome are limited. We evaluated the prevalence and extension of MaVI in a large cohort of consecutive HCC patients, analysing its association with liver disease and tumour characteristics, as well as with treatments performed and patients' survival. Methods: We analysed data of 4774 patients diagnosed with HCC recorded in the Italian Liver Cancer (ITA.LI.CA) database (2008-2018). Recursive partition analysis (RPA) was performed to evaluate interactions between MaVI, clinical variables and treatment, exploring the inter-relationship determining overall survival. Results: MaVI prevalence was 11.1%, and median survival of these patients was 6.0months (95% CI, 5.1-7.1). MaVI was associated with younger age at diagnosis, presence of symptoms, worse Performance Status (PS) and liver function, high alphafetoprotein levels and large HCCs. MaVI extension was associated with worse PS, ascites and greater impairment in liver function. RPA identified patients' categories with different treatment indications and survival, ranging from 2.4months in those with PS>1 and ascites, regardless of MaVI extension (receiving best supportive care in 90.3% of cases), to 14.1months in patients with PS 0-1, no ascites and Vp1-Vp2 MaVI (treated with surgery in 19.1% of cases). Conclusions: MaVI presence and extension, together with PS and ascites, significantly affect patients' survival and treatment selection. The decision tree based on these parameters may help assess patients' prognosis and inform therapeutic decisions.

Published
2021

2. Metabolic disorders across hepatocellular carcinoma in Italy

Author

Morisco, F., Guarino, M., Valvano, M. R., Auriemma, F., Farinati, F., Giannini, E. G., Ciccarese, F., Tovoli, F., Rapaccini, Gian Ludovico, Di Marco, M., Caturelli, E., Zoli, M., Borzio, F., Sacco, R., Cabibbo, G., Felder, M., Benvengu, L., Gasbarrini, Antonio, Svegliati Baroni, G., Foschi, F. G., Biasini, E., Masotto, A., Virdone, R., Marra, F., Caporaso, N., Trevisani, F., Sessa, A., Marafatto, F., Peserico, G., Pozzan, C., Brunacci, M., Moscatelli, A., Pellegatta, G., Savarino, V., Del Poggio, P., Olmi, S., De Matthaeis, Nicoletta, Balsamo, C., Vavassori, E., Roselli, P., Lauria, V., Pelecca, G., Mismas, V., Rossi, M., Attardo, S., Cavani, G., Mega, A., Rinninella, Emanuele, Ortolani, A., Bevilacqua, V., Chiara Dall'Aglio, A., Ercolani, G., Fiorini, Carlo Ettore, Casadei Gardini, A., Lanzi, Alessio, Mirici Cappa, F., Missale, G., Porro, E., Marchetti, F., Valerio, M., Affronti, A., Orlando, E., Rosa Barcellona, M., Aburas, S., Dragoni, G., Campani, C., Biselli, M., Bucci, L., Caraceni, P., Cucchetti, A., Domenicali, M., Garuti, F., Gramenzi, A., Magalotti, D., Serra, C., Granito, A., Negrini, G., Napoli, L., Piscaglia, F., Morisco, F., Guarino, M., Valvano, M. R., Auriemma, F., Farinati, F., Giannini, E. G., Ciccarese, F., Tovoli, F., Rapaccini, G. L., Di Marco, M., Caturelli, E., Zoli, M., Borzio, F., Sacco, R., Cabibbo, G., Felder, M., Benvengu, L., Gasbarrini, A., Svegliati Baroni, G., Foschi, F. G., Biasini, E., Masotto, A., Virdone, R., Marra, F., Caporaso, N., Trevisani, F., Sessa, A., Marafatto, F., Peserico, G., Pozzan, C., Brunacci, M., Moscatelli, A., Pellegatta, G., Savarino, V., Del Poggio, P., Olmi, S., de Matthaeis, N., Balsamo, C., Vavassori, E., Roselli, P., Lauria, V., Pelecca, G., Mismas, V., Rossi, M., Attardo, S., Cavani, G., Mega, A., Rinninella, E., Ortolani, A., Bevilacqua, V., Chiara Dall'Aglio, A., Ercolani, G., Fiorini, E., Casadei Gardini, A., Lanzi, A., Mirici Cappa, F., Missale, G., Porro, E., Marchetti, F., Valerio, M., Affronti, A., Orlando, E., Rosa Barcellona, M., Aburas, S., Dragoni, G., Campani, C., Biselli, M., Bucci, L., Caraceni, P., Cucchetti, A., Domenicali, M., Garuti, F., Gramenzi, A., Magalotti, D., Serra, C., Granito, A., Negrini, G., Napoli, L., Piscaglia, F., Morisco, Filomena, Guarino, Maria, Valvano, Maria R., Auriemma, Francesco, Farinati, Fabio, Giannini, Edoardo G., Ciccarese, Francesca, Tovoli, Francesco, Rapaccini, Gian Ludovico, Di Marco, Maria, Caturelli, Eugenio, Zoli, Marco, Borzio, Franco, Sacco, Rodolfo, Cabibbo, Giuseppe, Felder, Martina, Benvengù, Luisa, Gasbarrini, Antonio, Svegliati Baroni, Gianluca, Foschi, Francesco G., Biasini, Elisabetta, Masotto, Alberto, Virdone, Roberto, Marra, Fabio, Caporaso, Nicola, Trevisani, Franco, Sessa, Anna, Marafatto, Filippo, Peserico, Giulia, Pozzan, Caterina, Brunacci, Matteo, Moscatelli, Alessandro, Pellegatta, Gaia, Savarino, Vincenzo, Del Poggio, Paolo, Olmi, Stefano, de Matthaeis, Nicoletta, Balsamo, Claudia, Vavassori, Elena, Roselli, Paola, Lauria, Valentina, Pelecca, Giorgio, Mismas, Valeria, Rossi, Margherita, Attardo, Simona, Cavani, Giulia, Mega, Andrea, Rinninella, Emanuele, Ortolani, Alessio, Bevilacqua, Vittoria, Chiara Dall'Aglio, Anna, Ercolani, Giorgio, Fiorini, Erica, Casadei Gardini, Andrea, Lanzi, Arianna, Mirici Cappa, Federica, Missale, Gabriele, Porro, Emanuela, Marchetti, Fabiana, Valerio, Matteo, Affronti, Andrea, Orlando, Emanuele, Rosa Barcellona, Maria, Aburas, Sami, Dragoni, Gabriele, Campani, Claudia, Biselli, Maurizio, Bucci, Laura, Caraceni, Paolo, Cucchetti, Alessandro, Domenicali, Marco, Garuti, Francesca, Gramenzi, Annagiulia, Magalotti, Donatella, Serra, Carla, Granito, Alessandro, Negrini, Giulia, Napoli, Lucia, Piscaglia, Fabio, Valvano, Maria R, Giannini, Edoardo G, and Foschi, Francesco G

Subjects
Oncology, Male, obesity, Databases, Factual, Hepatocellular carcinoma, 0302 clinical medicine, Risk Factors, Prospective cohort study, diabetes, Metabolic disorder, Liver Neoplasms, Diabetes, hepatocellular carcinoma, Middle Aged, Metabolic syndrome, Portal vein thrombosis, Italy, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, Female, medicine.medical_specialty, Carcinoma, Hepatocellular, Settore MED/12 - GASTROENTEROLOGIA, Obesity, metabolic syndrome, 03 medical and health sciences, Databases, Metabolic Diseases, Internal medicine, medicine, Diabetes Mellitus, Humans, Factual, Aged, Neoplasm Staging, Retrospective Studies, Hepatology, business.industry, Carcinoma, Hepatocellular, medicine.disease, Survival Analysis, BCLC Stage, Multivariate Analysis, diabete, Liver function, business
Abstract

Background: Metabolic disorders are well-known risk factors for HCC. Conversely, their impact on the natural history of HCC is not established. This study aimed at evaluating the impact of metabolic disorders on clinical features, treatment and survival of HCC patients regardless of its aetiology. Methods: We analysed the ITA.LI.CA database regarding 839 HCC patients prospectively collected. The following metabolic features were analysed: BMI, diabetes, arterial hypertension, hypercholesterolaemia and hypertriglyceridaemia. According to these features, patients were divided into 3 groups: 0-1, 2 and 3-5 metabolic features. Results: As compared with patients with 0-1 metabolic features, patients with 3-5 features showed lower percentage of HCC diagnosis on surveillance (P=.021), larger tumours (P=.038), better liver function (higher percentage of Child-Pugh class A [P=.007] and MELD&nbsp

Published
2018

3. Rise and fall of HCV-related hepatocellular carcinoma in Italy: a long-term survey from the ITA.LI.CA centres

Author

Cazzagon N, Maddalo G, Giacomin A, Vanin V, Pozzan C, Del Poggio P, Rapaccini G, Di Nolfo AM, Benvegnù L, Borzio F, Giannini EG, Caturelli E, Chiaramonte M, Foschi FG, Cabibbo G, Felder M, Ciccarese F, Missale G, Svegliati Baroni G, Morisco F, Farinati F, The Italian Liver Cancer Group [. . ., DOMENICALI, MARCO, TREVISANI, FRANCO, ZOLI, MARCO, BOLONDI, LUIGI, BERNARDI, MAURO, Cazzagon, N, Trevisani, F, Maddalo, G, Giacomin, A, Vanin, V, Pozzan, C, Del Poggio, P, Rapaccini, G, Di Nolfo, AM, Benvegnù, L, Zoli, M, Borzio, F, Giannini, EG, Caturelli, E, Chiaramonte, M, Foschi, FG, Cabibbo, G, Felder, M, Ciccarese, F, Missale, G, Svegliati Baroni, G, Morisco, F, Pecorelli, A, Farinati, F., Di Nolfo, Am, Benvegn?, L, Giannini, Eg, Foschi, Fg, Morisco, Filomena, Farinati, F, CA Group, for the I. T. A. L. I., Cazzagon N, Trevisani F, Maddalo G, Giacomin A, Vanin V, Pozzan C, Del Poggio P, Rapaccini G, Di Nolfo AM, Benvegnù L, Zoli M, Borzio F, Giannini EG, Caturelli E, Chiaramonte M, Foschi FG, Cabibbo G, Felder M, Ciccarese F, Missale G, Svegliati Baroni G, Morisco F, Pecorelli A, Farinati F, The Italian Liver Cancer (ITA.LI.CA) Group [.., Bernardi M, and ]

Subjects
Male, medicine.medical_specialty, Carcinoma, Hepatocellular, Cirrhosis, Hepatitis C virus, hepatitis C, hepatocellular carcinoma, cirrhosis, medicine.disease_cause, Gastroenterology, Group B, Sex Factors, Internal medicine, Epidemiology, Prevalence, medicine, Humans, HEPATOCELLULAR CARCINOMA, CIRRHOSIS, Retrospective Studies, Hepatology, business.industry, Incidence, Liver Neoplasms, Age Factors, Retrospective cohort study, Hepatitis C, medicine.disease, Survival Analysis, digestive system diseases, Surgery, Italy, Hepatocellular carcinoma, Etiology, Female, business
Abstract

Background & Aims Hepatitis C virus (HCV) is the leading aetiological factor of HCC in the western world where, overall, its incidence is increasing, despite data suggesting an initial drop in some areas. The aim of this study was to evaluate epidemiology, clinical features and survival of HCV-related HCC (HCV-HCC) in a wide time range in Italy. Methods Multicentre retrospective study including 3695 patients prospectively recruited by the ITA.LI.CA group. Patients were classified into three subgroups according to aetiology (Group A[GA], pure HCV; Group B[GB], HCV + cofactors; and Group C[GC], non-HCV) and in 5 time cohorts (5 years each), according to the year of diagnosis. Age, gender, Child–Pugh score, modality of diagnosis, stage, presence of thrombosis/metastases, type of treatment and survival were analysed. Results A total of 1801 GA patients, 445 GB and 1333 GC were recruited. The number of GA patients peaked in the 1996–2000, gradually dropping thereafter (P

Published
2013

4. HCV infection is a risk factor for gallstone disease in liver cirrhosis: an Italian epidemiological survey

Author

Stroffolini, T., Sagnelli, E., Mele, A., Cottone, C., Almasio, P. L., Traverso, A., Arrigoni, A., Torchio, M., Garbagnoli, P., Del Mastro, B., Romano, P., Vanni, R., Brusita, D., Meucci, P., Cassola, G., Borzio, M., Bellobuono, A., De Bona, A., Re, T., Del Poggio, P., Baisini, O., Colombo, A., Attolini, C., Daria, S., MINOLI, MARIA LAURA, Gazzaniga, V., Segato, S., ORIOLO, MARIA, Parlotto, A., Ghersetti, M., CAPRA, FRANCESCA, Muratori, R., Sama, C., BOCCIA, SARA, Verdianelli, G., PRATICO', ANTONIO, GRANDI, MARIO, VENTURA, ELISA, Cantoni, F., Vincenti, A., Nerli Alessandro, A., Galeazzi, L., SOLINAS, ALICE, Paroli, M., De Sanctis, G. M., Sereno, S., Clementi, C., Visco Comandino, U., Gallo, A. I., Festi, D., Sabusco, G., Coppola, N., Scolastico, C., Onofrio, M., Imparato, M., Filippini, P., Morisco, F., Liberti, A., BORGIA, GIULIO CESARE, Scarpellino, F., Persico, M., Sagnelli, C., COPPOLA, CLAUDIO, Caserta, L., Elia, A., De Vita, G., Lanzotti, A., Pizzolante, L., Messina, V., Fiore, G., Agostinacchio, E., Santantonio, T., Mazzola, M., Vinelli, F., Campagna, A., Cataldini, S., Monelli, I., Lascaro, M., Polimeri, N., Frugiuele, P., Ferraro, M., Prestileo, T., Alessandri, A., Russello Maurizio, M., Bellissima, P., Orifici, G., Pisani, G., Angioini, S., Lai, M., Spanneda, M., Stroffolini, T., Sagnelli, E., Mele, A., Cottone, C., Almasio, P.L., Traverso, A., Arrigoni, A., Torchio, M., Garbagnoli, P., Del Mastro, B., Romano, P., Vanni, R., Brusita, D., Meucci, P., Cassola, G., Borzio, M., Bellobuono, A., De Bona, A., Re, T., Del Poggio, P., Baisini, O., Colombo, A., Attolini, C., Daria, S., Minoli, L., Gazzaniga, V., Segato, S., Oriolo, M., Parlotto, A., Ghersetti, M., Capra, F., Muratori, R., Sama, C., Boccia, S., Verdianelli, G., Praticò, A., Grandi, M., Ventura, E., Cantoni, F., Vincenti, A., Nerli Alessandro, A., Galeazzi, L., Solinas, A., Paroli, M., De Sanctis, G.M., Sereno, S., Clementi, C., Visco Comandino, U., Gallo, A.I., Festi, D., Sabusco, G., Coppola, N., Scolastico, C., Onofrio, M., Imparato, M., Filippini, P., Morisco, F., Liberti, A., Borgia, G., Scarpellino, F., Persico, M., Sagnelli, C., Coppola, C., Caserta, L., Elia, A., De Vita, G., Lanzotti, A., Pizzolante, L., Messina, V., Fiore, G., Agostinacchio, E., Santantonio, T., Mazzola, M., Vinelli, F., Campagna, A., Cataldini, S., Monelli, I., Lascaro, M., Polimeri, N., Frugiuele, P., Ferraro, M., Prestileo, T., Alessandri, A., Russello Maurizio, M., Bellissima, P., Orifici, G., Pisani, G., Angioini, S., Lai, M., and Spanneda, M.

Subjects
Liver Cirrhosis, Adult, Male, HBsAg, medicine.medical_specialty, Cirrhosis, Alcohol Drinking, Liver Cirrhosi, Gallbladder disease, Prevalence, Infectious Disease, Gallstones, Gastroenterology, Liver disease, Risk Factors, Virology, Internal medicine, HBV, medicine, Humans, Cholecystectomy, Risk factor, Aged, Cirrhosi, Hepatology, business.industry, Risk Factor, Hepatitis C, Hepatitis C, Chronic, Middle Aged, medicine.disease, Infectious Diseases, Italy, Gallstone, HCV, Chronic hepatiti, Female, business, Human
Abstract

We assessed the prevalence of gallbladder disease (i.e. gallstones plus cholecystectomy) among patients with liver disease and its association with the severity and aetiology of hepatic injury. Subjects, referred to 79 Italian hospitals, were enrolled in a 6-month period. The independent effect of the severity and aetiology of liver disease on gallstone disease prevalence was assessed by multiple logistic regression analysis. Overall, 4867 subjects tested anti-hepatitis C virus (HCV) positive alone, 839 were hepatitis B virus surface antigen (HBsAg) alone, and 652 had an excessive alcohol intake. The prevalence of gallstone disease was 23.3% in anti-HCV-positive patients, 12.4% in HBsAg positive and 24.2% in subjects reporting excessive alcohol intake, respectively. Gallstone disease prevalence increased by age in each aetiological category. The proportion of patients with gallstone disease who had a cholecystectomy was the highest in HCV+ subjects. After adjusting for the confounding effect of age and body mass index, compared with patients with less severe liver disease, subjects with HCV-related cirrhosis, but not those with alcohol-related cirrhosis, were more likely to have gallstone disease. Subjects with HCV-related cirrhosis (OR 2.13, 95% CI: 1.38-3.26) were more likely to have gallstone disease when compared with those with HBV-related cirrhosis. HCV infection is a risk factor for gallstone disease. In Italy, the high prevalence of HCV infection among cirrhotic patients has important implications, as cholecystectomy in these subjects is associated with high risk of morbidity and mortality. © 2007 The Authors.

Published
2007

5. A different perspective on sofosbuvir-ledipasvir treatment of patients with HCV genotype 1b cirrhosis: The ital-c network study

Author

Barone, M., primary, Iannone, A., additional, Shahini, E., additional, Ippolito, A. M., additional, Brancaccio, G., additional, Morisco, F., additional, Milella, M., additional, Messina, V., additional, Smedile, A., additional, Conti, F., additional, Gatti, P., additional, Santantonio, T., additional, Tundo, P., additional, Lauletta, G., additional, Napoli, N., additional, Masetti, C., additional, Termite, A. P., additional, Francavilla, R., additional, Di Leo, A., additional, Pesce, F., additional, and Andriulli, A., additional

Published
2017
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8. Effect of immunosuppressive therapy on patients with inflammatory bowel diseases and hepatitis B or C virus infection

Author

Morisco, F., primary, Castiglione, F., additional, Rispo, A., additional, Stroffolini, T., additional, Sansone, S., additional, Vitale, R., additional, Guarino, M., additional, Biancone, L., additional, Caruso, A., additional, D'Inca, R., additional, Marmo, R., additional, Orlando, A., additional, Riegler, G., additional, Donnarumma, L., additional, Camera, S., additional, Zorzi, F., additional, Renna, S., additional, Bove, V., additional, Tontini, G., additional, Vecchi, M., additional, and Caporaso, N., additional

Published
2012
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11. Migratory flow and hepatitis delta infection in Italy: A new challenge at the beginning of the third millennium

Author

Tommaso Stroffolini, Alessia Ciancio, Caterina Furlan, Maria Vinci, Rosanna Fontana, Maurizio Russello, Guido Colloredo, Filomena Morisco, Nicola Coppola, Sergio Babudieri, Luigina Ferrigno, Caterina Sagnelli, Evangelista Sagnelli, Giulia Verzon, Arianna Latanza, Viviana Picciotto, Grazia Anna Niro, Rosa Grazia Benigno, Giuseppina Pontillo, Vincenzo Messina, Vito Fiore, Stroffolini, T., Ciancio, A., Furlan, C., Vinci, M., Fontana, R., Russello, M., Colloredo, G., Morisco, F., Coppola, N., Babudieri, S., Ferrigno, L., Sagnelli, C., and Sagnelli, E.

Subjects
Male, HBsAg carriers, Cirrhosis, Multivariate analysis, viruses, Emigrants and Immigrants, 03 medical and health sciences, 0302 clinical medicine, Virology, Prevalence, Advanced disease, Humans, Medicine, Multiple logistic regression analysis, Hepatitis Antibodies, 030212 general & internal medicine, Hepatology, HDV infection, HDV infection endemicity, business.industry, HEPATITIS DELTA, virus diseases, Mean age, Middle Aged, biochemical phenomena, metabolism, and nutrition, medicine.disease, Hepatitis D, HBsAg carrier, Infectious Diseases, Italy, Female, 030211 gastroenterology & hepatology, Hbsag carrier, Hepatitis Delta Virus, business, Demography
Abstract

In Italy, HDV infection endemicity has greatly decreased overtime. Migratory flow may change this scenario as migrants often come from high HDV endemicity areas. Here, we studied characteristics of HDV infection in Italy, particularly addressed to the birth area of subjects. Chronic HBsAg carriers consecutively referring to 9 units in Italy prospectively enrolled for a six-month period in 2019 were tested for anti-HDV by ELISA. Multiple logistic regression analysis was performed to identify anti-HDV positivity independent predictors. A total of 894 HBsAg-positive subjects were enrolled. Of them, 786 (87.9%) were tested for anti-HDV. Anti-HDV overall prevalence was 9.9% (6.4% in Italian natives and 26.4% in non-natives; P&nbsp

Published
2020

12. Variation in genes encoding for interferon λ-3 and λ-4 in the prediction of HCV-1 treatment-induced viral clearance

Author

Raffaele Cozzolongo, Antonio Massimo Ippolito, Lydia Giannitrapani, Michele Milella, Filomena Morisco, Teresa Santantonio, Maria Rosa Valvano, Domenica Gioffreda, Angelo Andriulli, Michele Barone, Giuseppe Corritore, Pietro Gatti, Nicola Andriulli, Anna Latiano, Massimo Fasano, Giovanna D'Andrea, R. Fontana, Paolo Tundo, Maurizio Margaglione, Orazio Palmieri, Palmieri, O., Ippolito, A., Margaglione, M., Valvano, M., Gioffreda, D., Fasano, M., D'Andrea, G., Corritore, G., Milella, M., Andriulli, N., Morisco, F., Giannitrapani, L., Latiano, A., Fontana, R., Gatti, P., Tundo, P., Barone, M., Cozzolongo, R., Santantonio, T., Andriulli, A., Palmieri, Orazio, Ippolito, Antonio M, Margaglione, Maurizio, Valvano, Maria Rosa, Gioffreda, Domenica, Fasano, Massimo, D'Andrea, Giovanna, Corritore, Giuseppe, Milella, Michele, Andriulli, Nicola, Morisco, Filomena, Giannitrapani, Lydia, Latiano, Anna, Fontana, Rosanna, Gatti, Pietro, Tundo, Paolo, Barone, Michele, Cozzolongo, Raffaele, Santantonio, Teresa, and Andriulli, Angelo

Subjects
Male, Oncology, Settore MED/09 - Medicina Interna, IL28B, peg-interferon, Bioinformatics, Polyethylene Glycol, Linkage Disequilibrium, Polyethylene Glycols, Cohort Studies, IL28B/interferon lambda-3 gene, chemistry.chemical_compound, Gene Frequency, peg-interferon/ribavirin, virus diseases, Recombinant Protein, Middle Aged, Viral Load, Hepatitis C, Recombinant Proteins, Treatment Outcome, HCV, Cohort, Female, Human, Adult, medicine.medical_specialty, interferon lambda-3 gene, Locus (genetics), Single-nucleotide polymorphism, Biology, chronic hepatiti, Internal medicine, Ribavirin, medicine, Humans, SNP, Allele, Genotyping, Gene, interferon lambda-4 gene, Aged, Polymorphism, Genetic, Hepatology, Interleukins, Interferon-alpha, Interleukin, digestive system diseases, chemistry, Interferons, Cohort Studie
Abstract

Background & Aims In patients with chronic HCV-1 infection, recent evidences indicate that determination of a dinucleotide polymorphism (ss469415590, ΔG/TT) of a new gene, designated IFN λ-4, might be more accurate than the 12979860CC type of the IL28B locus in predicting sustained virological response (SVR) following peg-interferon and ribavirin. In addition, combined genotyping of different SNPs of the IL28B locus was shown to help dissect patients most prone to SVR among those with rs12979860CT. We examined whether single or combined genotyping of two IL28B SNPs, rs12979860 and rs8099917, and ss469415590 variation might improve the prediction of SVR. Results In the study cohort of 539 patients, 38% had SVR. The SNPs 12979860CC, rs8099917TT, and rs469415590TT/TT correlated significantly with SVR (68%, 50%, and 67%). Carriers of either the triplotype rs12979860CC_ss469415590TT/TT_rs8099917TT or the diplotype rs12979860CC_ss469415590TT/TT had the highest SVR rate (72%). In carriers of the rs12979860 T allele, neither the rs8099917 nor the ss469415590 improved the response prediction. After pooling this finding with data from previous studies, in rs12979860 T heterozygous individuals the co-presence of the rs8099917TT SNP was associated with improved response prediction. Conclusion In HCV-1 patients, the rs12979860 polymorphism appeared as the hit SNP better predicting response following peg-interferon and ribavirin treatment. Additional ss469415590 or rs8099917 genotyping had no added benefit for response prediction. In the subset of carriers of the rs12979860 T allele, genotyping of the rs8099917 SNP was unhelpful in the present investigation, but may inform clinical prediction of treatment response when our data were pooled with previous investigations.

Published
2013

13. Determination of plasma alpha-glutathione S-transferases in patients with HCV-related chronic infection: its significance and possible clinical relevance

Author

Ciro Guerriero, Filomena Morisco, Camillo Del Vecchio Blanco, Salvatore Scotto Di Santolo, Lucio Mario Valenza, Giovanna Del Vecchio Blanco, Carmela Loguercio, Concetta Tuccillo, Nicola Caporaso, Loguercio, Carmelina, Tuccillo, C, Caporaso, N, DEL VECCHIO BLANCO, G, Morisco, F, Guerriero, C, DI SANTOLO, S, Valenza, Lm, DEL VECCHIO BLANCO, C., Loguercio, C, Caporaso, Nicola, Morisco, Filomena, and SCOTTO DI SANTOLO, S

Subjects
Adult, Male, medicine.medical_specialty, Cirrhosis, Adolescent, Hepatitis C virus, Hepacivirus, Biology, Chronic liver disease, medicine.disease_cause, Gastroenterology, Internal medicine, Blood plasma, medicine, Humans, Clinical significance, Child, Glutathione Transferase, Hepatology, Middle Aged, medicine.disease, Hepatitis C, digestive system diseases, Chronic infection, Hepatocellular carcinoma, Chronic Disease, Immunology, Female, Liver function, Biomarkers
Abstract

AIMS/BACKGROUND Alpha-glutathione S-transferases (alpha-GST) are the cytoplasmatic class of enzymes responsible for cellular detoxifying processes. We evaluated the plasma alpha-GST activity in relation to chronic infection caused by hepatitis C virus (HCV). METHODS Eighteen anti-HCV-negative healthy subjects (controls), 32 anti-HCV-positive subjects with a constant normality of alanine aminotransferases (ALT) and gamma-glutamyl transpeptidase (gamma-GT) levels ("apparently healthy carriers"), and 85 patients with HCV-related chronic liver disease (40 chronic hepatitis, 27 cirrhosis, and 18 with hepatocellular carcinoma) were studied. We assayed plasma alpha-GST in all subjects upon their entry into the study; and every 6 months for 3 years in the control group and in anti-HCV apparently healthy carriers. RESULTS Alpha-GST values were significantly higher than normal values in 57% of the 21 HCV-RNA-positive apparently healthy carriers and in none of 11 persistently HCV-RNA-negative subjects; the highest increment of alpha-GST was documented in patients with chronic hepatitis. We did not observe correlation among HCV-RNA, histological activity, gamma-GT and ALT or alpha-GST values. CONCLUSIONS Therefore, the increment of plasma alpha-GST indicates a liver involvement even when ALT levels are normal. This may be clinically relevant to "apparently healthy carriers" whose plasma alpha-GST values, when increased, might need further evaluation.

Published
2008

14. Predicting de-novo portal vein thrombosis after HCV eradication: A long-term competing risk analysis in the ongoing PITER cohort.

Author

Kondili LA, Zanetto A, Quaranta MG, Ferrigno L, Panetta V, Calvaruso V, Zignego AL, Brunetto MR, Raimondo G, Biliotti E, Ieluzzi D, Iannone A, Madonia S, Chemello L, Cavalletto L, Coppola C, Morisco F, Barbaro F, Licata A, Federico A, Cerini F, Persico M, Pompili M, Ciancio A, Piscaglia F, Chessa L, Giacometti A, Invernizzi P, Brancaccio G, Benedetti A, Baiocchi L, Gentile I, Coppola N, Nardone G, Craxì A, and Russo FP

Subjects
Humans, Antiviral Agents therapeutic use, Portal Vein, Liver Cirrhosis diagnosis, Liver Cirrhosis epidemiology, Liver Cirrhosis complications, Risk Assessment, Albumins therapeutic use, Bilirubin, Esophageal and Gastric Varices complications, Hepatitis C, Chronic complications, Hepatitis C, Chronic diagnosis, Hepatitis C, Chronic drug therapy, Venous Thrombosis diagnosis, Venous Thrombosis epidemiology, Venous Thrombosis etiology
Abstract

Background & Aims: Sustained virological response (SVR) by direct-acting antivirals (DAAs) may reverse the hypercoagulable state of HCV cirrhosis and the portal vein thrombosis (PVT) risk. We evaluated the incidence and predictive factors of de novo, non-tumoral PVT in patients with cirrhosis after HCV eradication., Methods: Patients with HCV-related cirrhosis, consecutively enrolled in the multi-center ongoing PITER cohort, who achieved the SVR using DAAs, were prospectively evaluated. Kaplan-Meier and competing risk regression analyses were performed., Results: During a median time of 38.3 months (IQR: 25.1-48.7 months) after the end of treatment (EOT), among 1609 SVR patients, 32 (2.0%) developed de novo PVT. A platelet count ≤120,000/μL, albumin levels ≤3.5 mg/dL, bilirubin >1.1 mg/dL, a previous liver decompensation, ALBI, Baveno, FIB-4, and RESIST scores were significantly different (p < 0.001), among patients who developed PVT versus those who did not. Considering death and liver transplantation as competing risk events, esophageal varices (subHR: 10.40; CI 95% 4.33-24.99) and pre-treatment ALBI grade ≥2 (subHR: 4.32; CI 95% 1.36-13.74) were independent predictors of PVT. After HCV eradication, a significant variation in PLT count, albumin, and bilirubin (p < 0.001) versus pre-treatment values was observed in patients who did not develop PVT, whereas no significant differences were observed in those who developed PVT (p > 0.05). After the EOT, esophageal varices and ALBI grade ≥2, remained associated with de novo PVT (subHR: 9.32; CI 95% 3.16-27.53 and subHR: 5.50; CI 95% 1.67-18.13, respectively)., Conclusions: In patients with HCV-related cirrhosis, a more advanced liver disease and significant portal hypertension are independently associated with the de novo PVT risk after SVR., (© 2023 The Authors. United European Gastroenterology Journal published by Wiley Periodicals LLC on behalf of United European Gastroenterology.)

Published
2024
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15. The role of antiplatelet therapies on incidence and mortality of hepatocellular carcinoma.

Author

Lai Q, De Matthaeis N, Finotti M, Galati G, Marrone G, Melandro F, Morisco F, Nicolini D, Pravisani R, and Giannini EG

Subjects
Humans, Incidence, Carcinoma, Hepatocellular epidemiology, Liver Neoplasms epidemiology
Abstract

Aim: To evaluate the impact of antiplatelet therapy (APT)on the incidence of hepatocellular carcinoma (HCC) and mortality following its treatment., Methods: A systematic literature search was performed using PubMed and Cochrane Central Register of Controlled Trials Databases. Two HCC clinical settings were explored: (i) incidence, and (ii) death after any HCC treatment. Odds ratios (OR) and 95% confidence intervals (95%CI) were calculated to compare the pooled data between patients who received or did not receive APT., Results: A total of 20 studies were identified, of whom 15 focused on HCC incidence, including 2,685,009 patients, and five on post-treatment death, including 3281 patients. APT was associated with an overall reduced risk of HCC incidence (OR: 0.63; 95%CI = 0.51-0.79; p < 0.001) as well as of post-treatment mortality (OR: 0.54; 95%CI = 0.35-0.83; p = 0.006)., Conclusions: Current data suggest that APT correlated with higher HCC incidence and poor overall survival following tumour treatment., (© 2022 The Authors. European Journal of Clinical Investigation published by John Wiley & Sons Ltd on behalf of Stichting European Society for Clinical Investigation Journal Foundation.)

Published
2023
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16. Dietary supplementation of vitamin D prevents the development of western diet-induced metabolic, hepatic and cardiovascular abnormalities in rats.

Author

Mazzone G, Morisco C, Lembo V, D'Argenio G, D'Armiento M, Rossi A, Giudice CD, Trimarco B, Caporaso N, and Morisco F

Abstract

Background: The western diet high in fat and fructose may cause metabolic disorders and cardiovascular diseases., Objective: To evaluate whether long-term daily vitamin D 3 supplementation prevents hepatic steatosis and cardiovascular abnormalities and restores insulin sensitivity caused by fat diet in rats without vitamin D deficiency., Methods: Three groups of rats were fed for 6 months with standard diet (SD), western diet (WD) or WD containing 23 IU/day/rat vitamin D 3 , respectively. Tail-cuff systolic blood pressure (SBP)measurements in conscious rats and transthoracic echocardiography were performed in basal condition, and after 3 and 6 months of diet. Hepatic steatosis and myocardial fibrosis were assessed in liver and cardiac tissues using standard methods. Serum insulin and 25(OH)D3 concentrations were determined using rat-specific ELISA kits. Insulin resistance was determined according to the homeostasis model assessment of insulin resistance (HOMA-IR) method., Results: Sixty-one per cent of hepatocytes in WD rats had steatotic vacuoles compared with just 27% in rats on a WD plus vitamin D 3 ( p  < 0.05).HOMA-IR was reduced in rats with vitamin D supplementation compared with WD alone (19.4 ± 5.2 vs 41.9 ± 8.9, p  < 0.05). Rat blood pressure and left ventricular mass were both reduced by vitamin D 3 supplementation., Conclusion: In animal models of liver and cardiovascular metabolic damage, the supplementation of vitamin D 3 shows liver and cardio-protective effects.

Published
2018
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17. Optimization of direct anti-viral agent treatment schedule: Focus on HCV genotype 3.

Author

Morisco F, Granata R, Camera S, Ippolito A, Milella M, Conti F, Masetti C, Smedile A, Tundo P, Santantonio T, Valvano MR, Termite A, Gatti P, Messina V, Iacobellis A, Librandi M, Caporaso N, and Andriulli A

Abstract

Background and Aim: Direct antiviral agents (DAAs) have led to high sustained virological responses (SVR) in hepatitis C virus (HCV) patients. However, genotype 3 patients respond to treatment in a suboptimal way. This study aims to identify which of the several treatment schedules recommended for genotype 3 would constitute the best option., Methods: Twenty-four Italian centers were involved in this real-life study of HCV genotype 3 patients treated with DAAs. To expand the number of cases, we conducted a systematic review of the literature on the outcome of genotype 3 patients treated with DAAs., Results: A total of 233 patients with HCV genotype 3 were enrolled. Cirrhotic patients accounted for 83.7%. Overall, the SVR12 rate was achieved by 205 patients (88.0%); the SVR rates were 78.8% after sofosbuvir/ribavirin, 92.5% after sofosbuvir/daclatasvir ± ribavirin, and 100% after sofosbuvir/ledipasvir (seven patients). No difference in rate of SVR was observed in cirrhotic and non-cirrhotic patients (92.2 vs 94.4) using a combination regimen of NS5A and NS5B inhibitors.The systematic review of the literature provided data of 3311 patients: The mean weighted SVR12 rate was 84.4% (CI: 80.4-87.8); the rates varied from 79.0% (CI: 70.9-85.3) with sofosbuvir/ribavirin, to 83.7% (CI: 66.2-93.1) with sofosbuvir/ledispavir, and to 88.2% (CI: 83.3-91.7) with sofosbuvir/daclatasvir., Conclusions: Our results reinforce the concept that patients with HCV genotype 3 should no longer be considered difficult-to-treat individuals. The optimal therapeutic regimen for these patients appears to be the combination sofosbuvir/daclatasvir, administered for 12 weeks without the use of RBV in non-cirrhotic patients. In cirrhotics the meta-analytic approach suggests extending therapy to 24 weeks.

Published
2018
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18. Determinants of alpha-fetoprotein levels in patients with hepatocellular carcinoma: implications for its clinical use.

Author

Giannini EG, Sammito G, Farinati F, Ciccarese F, Pecorelli A, Rapaccini GL, Di Marco M, Caturelli E, Zoli M, Borzio F, Cabibbo G, Felder M, Gasbarrini A, Sacco R, Foschi FG, Missale G, Morisco F, Svegliati Baroni G, Virdone R, and Trevisani F

Subjects
Adult, Aged, Alanine Transaminase blood, Bilirubin blood, Carcinoma, Hepatocellular enzymology, Carcinoma, Hepatocellular pathology, Carcinoma, Hepatocellular virology, Cohort Studies, Female, Hepatitis C complications, Humans, Italy, Liver Cirrhosis complications, Liver Function Tests, Liver Neoplasms enzymology, Liver Neoplasms pathology, Liver Neoplasms virology, Male, Middle Aged, Neoplasm Staging, Prognosis, Serum Albumin metabolism, Sex Factors, Biomarkers, Tumor blood, Carcinoma, Hepatocellular blood, Carcinoma, Hepatocellular etiology, Liver Neoplasms blood, Liver Neoplasms etiology, alpha-Fetoproteins metabolism
Abstract

Background: α-Fetoprotein (AFP) is a biomarker commonly used in the management of patients with hepatocellular carcinoma (HCC), although the possible determinants of its serum levels in these patients have not been adequately explored. For this study, the authors evaluated the relevance of demographic, clinical, and oncologic factors to the presence of elevated AFP levels in large cohort of patients with HCC., Methods: In 4123 patients with HCC who were managed by the Italian Liver Cancer Group, AFP levels were assessed along with their association with demographic, biochemical, clinical, and oncologic characteristics. Patients were subdivided according to the presence of elevated AFP (ie, >10 ng/mL)., Results: AFP levels were elevated in 62.4% of patients with HCC. Multivariate logistic regression analysis indicated that being a woman (odds ratio [OR], 1.497; 95% confidence interval [95%CI], 1.250-1.793; P < .0001), the presence of cirrhosis (OR, 1.538; 95% CI, 1.050-2.254; P = .027), liver disease with viral etiology (OR, 1.900; 95% CI, 1.589-2.272; P < .0001), an elevated alanine aminotransferase level (OR, 1.878; 95% CI, 1.602-2.202; P < .0001), a low albumin level (OR, 1.301; 95% CI, 1.110-1.525; P = .012), an HCC tumor size >2 cm (OR, 1.346; 95% CI, 1.135-2.596; P = .001), multinodular HCC (OR, 1.641; 95% CI, 1.403-1.920; P < .0001), and the presence of vascular invasion (OR, 1.774; 95% CI, 1.361-2.311; P < .0001) were associated independently with elevated levels of AFP. Both the median AFP level and the proportion of patients who had elevated levels increased with decreasing degrees of HCC differentiation (P < .0001)., Conclusions: Sex and features of chronic liver disease were identified as nontumor characteristics that influence serum AFP levels in patients with HCC. These findings should be taken into account as limitations in interpreting the oncologic meaning of this biomarker in clinical practice., (© 2014 American Cancer Society.)

Published
2014
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19. Analysis of breath by proton transfer reaction time of flight mass spectrometry in rats with steatohepatitis induced by high-fat diet.

Author

Aprea E, Morisco F, Biasioli F, Vitaglione P, Cappellin L, Soukoulis C, Lembo V, Gasperi F, D'Argenio G, Fogliano V, and Caporaso N

Subjects
Analysis of Variance, Animals, Biomarkers analysis, Diet, High-Fat, Fatty Liver chemically induced, Male, Rats, Rats, Wistar, Breath Tests methods, Fatty Liver metabolism, Mass Spectrometry methods, Volatile Organic Compounds analysis
Abstract

Breath testing has been largely used as a diagnostic tool, but the difficulties in data interpretation and sample collection have limited its application. We developed a fast (< 20 s), on-line, non-invasive method for the collection and analysis of exhaled breath in awake rats based on proton transfer reaction time of flight mass spectrometry (PTR-ToF-MS) and applied it to investigate possible relationships between pathologies induced by dietary regime and breath composition. As a case study, we investigated rats with dietary induced non-alcoholic steatohepatitis (NASH) and modifications induced by coffee addition to the diet. We considered two different diets (standard and high fat) complemented with two different drinking possibilities (water or decaffeinated coffee) for a total of four groups with four rats each. Several spectrometric peaks were reliable markers for both dietary fat content and coffee supplementation. The high resolution and accuracy of PTR-ToF-MS allowed the identification of related compounds such as methanol, dimethyl sulphide, dimethyl sulphone and ammonia. In conclusion, the rapid and minimally invasive breath analysis of awake rats permitted the identification of markers related to diet and specific pathologic conditions and provided a useful tool for broader metabolic investigations., (Copyright © 2012 John Wiley & Sons, Ltd.)

Published
2012
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20. Serum insulin-like growth factor I evaluation as a useful tool for predicting the risk of developing hepatocellular carcinoma in patients with hepatitis C virus-related cirrhosis: a prospective study.

Author

Mazziotti G, Sorvillo F, Morisco F, Carbone A, Rotondi M, Stornaiuolo G, Precone DF, Cioffi M, Gaeta GB, Caporaso N, and Carella C

Subjects
Adult, Aged, Aged, 80 and over, Carcinoma, Hepatocellular virology, Female, Humans, Liver Neoplasms virology, Male, Middle Aged, Prognosis, Prospective Studies, Risk Factors, Sensitivity and Specificity, alpha-Fetoproteins metabolism, Carcinoma, Hepatocellular blood, Hepatitis C complications, Insulin-Like Growth Factor I metabolism, Liver Cirrhosis virology, Liver Neoplasms blood
Abstract

Background: Although experimental studies have demonstrated an important role of insulin-like growth factor I (IGF-I) in hepatocarcinogenesis, the clinical data about IGF-I in patients with hepatocellular carcinoma (HCC) are scarce and controversial. To the authors' knowledge, this is the first prospective study investigating the longitudinal correlation between modifications in serum IGF-I levels and the development of HCC in a cohort of patients with hepatitis C virus (HCV)-related cirrhosis., Methods: One hundred fourteen consecutive patients with HCV-related Child Grade A cirrhosis were followed prospectively at the Second University of Naples for 56.4 +/- 12.0 months with ultrasound examinations of the liver and serum alpha-fetoprotein determination every 6 months. At each clinical evaluation, the severity of disease was graded according to the established Child-Pugh scoring system. Serum IGF-I levels were measured prospectively at the study entry and at least every 12 months throughout follow-up., Results: Twenty patients (19.2%) developed HCC during follow-up. Eleven of these patients had persistent Child Grade A cirrhosis for the whole study, whereas the other 9 patients developed HCC after their cirrhosis progressed from Child Grade A to Grade B. In patients who remained free of HCC for the whole study, serum IGF-I concentrations did not modify significantly during follow-up. Conversely, in patients who developed HCC, IGF-I levels decreased significantly during follow-up (from 72.6 +/- 29.9 microg/L to 33.8 +/- 14.5 microg/L; P = 0.001). In these patients, the significant decrease occurred both in patients with persistent Child Grade A cirrhosis and in patients with cirrhosis that progressed from Child Grade A to Grade B. The reduction in IGF-I level preceded the diagnosis of HCC by 9.3 +/- 3.1 months., Conclusions: This prospective study demonstrates that, in patients with HCV-related cirrhosis, 1) the development of HCC is accompanied by a significant reduction of serum IGF-I levels independent of the grade of impairment of liver function; and 2) modification of the IGF-I level precedes the morphologic appearance of HCC, permitting a precocious diagnosis of the tumor., (Copyright 2002 American Cancer Society.DOI 10.1002/cncr.11002)

Published
2002
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