SEX-HORMONES IN PATIENTS WITH LIVER-CIRRHOSIS AND HEPATOCELLULAR-CARCINOMA

Sex hormones have been proposed to play an important role in promoting liver cancer transformation. The aim of our study was to evaluate cha nges in circulating levels of estradiol (EII), testosterone (T) and th e EII/T relationship (ETR) in patients with liver cirrhosis (LC) and h epatocellular carcinoma (HCC) of viral origin compared with a group of healthy controls (C). The study population included 64 patients (41 M ) mean age 62.5 years with HCC; 68 patients (41 M) mean age 61.3 years suffering from LC, while the C included 59 subjects (39 M) mean age 6 0.0 years recruited from voluntary blood donors. EII and T were assaye d using the IEMA method; ultrasonography was performed using a Toshiba SSA 240 A scanner with a convex 3.75 MHz probe. Serum EII levels prog ressively increased from C to LC and HCC with statistically significan t values (H=36.9, p<0.0001). Serum values of T progressively decreased from C to LC and HCC but the difference was not significant (H=3.84, p=ns). ETR values differed in the three groups, with a significant dif ference between C vs LC and HCC (p<0.0001). There was also a significa nt difference for EII, with values decreasing as the neoplasm dimensio n increased (p<0.04), and in particular there were differences between HCC <5 cm vs >5 cm (p<0.05). In contrast, ETR progressively increased as the diameter of neoplasm increased, but differences were significa nt only between <3 cm vs >5 cm (p<0.05). In conclusion, our data confi rm that in LC and HCC there is an increase in serum EII levels, which can be important in the genesis of liver carcinoma. Progressive serum reduction in T may be due to increased androgen uptake and progressive accumulation within the neoplastic mass. Further studies are necessar y to determine whether subjects with LC and elevated serum levels of e strogens are at higher risk of developing HCC.