PREDICTIVE VALUE OF SERUM SEX-HORMONE BINDING GLOBULIN FOR THE OCCURRENCE OF HEPATOCELLULAR-CARCINOMA IN MALE-PATIENTS WITH CIRRHOSIS

Background/Aims: The incidence of hepatocellular carcinoma is higher i n males, presumably due to the influence of sex steroids. Therefore, t o further assess the role of sex steroids in the occurrence of hepatoc ellular carcinoma, this study investigated the predictive value of dif ferent sex hormones and their binding protein. Methods: Among 101 male patients with cirrhosis included in a prospective screening study, 29 developed hepatocellular carcinoma. We assessed the predictive value of 17 clinico-biological and 4 serum hormonal variables collected at e nrollment, by the log-rank test and the Cox model. Results: Age (p=0.0 03), bilirubin (p=0.04), sex-hormone-binding-globulin (p=0.006) and al bumin (p=0.08) were predictive using the log-rank test, while estradio l and total and free testosterone were not. The Cox model showed age ( p=0.0003; relative risk=7.52), sex-hormone-binding globulin (p=0.001, relative risk=3.37) and albumin (p=0.02, relative risk=2.94) as the mo st predictive parameters. Conclusion: We conclude that high serum sex- hormone-binding-globulin levels have an independent predictive value f or the occurrence of hepatocellular carcinoma. Serum sex-hormone-bindi ng-globulin could be used to define patients at high risk for hepatoce llular carcinoma and could hypothetically play a role in hepatocarcino genesis.