May plasma cholesterol level be considered a neoplastic marker in liver disease from cirrhosis to hepatocellular carcinoma?

Background. Although the role of cholesterol in tumourigenesis is unclear; it is used by the tumoural cells for biosynthetic processes and for steroid synthesis. Aim, To accertain whether plasma cholesterol levels might be a reliable neo plastic marker of a developing hepatocellular carcinoma in patients with li ver cirrhosis. Patients, Plasma cholesterol has been studied in 287 liver cirrhosis patien ts without hepatocellular carcinoma and in 132 patients with hepatocellular carcinoma. Results, Cholesterol (mean +/- SEM) was higher in hepatocellular carcinoma patients when compared with age-, sex- and Child-Pugh class matched cirrhot ic controls. In Child-Pugh class A, B and C with uncomplicated liver cirrho sis these values were, respectively 142.0 +/- 2.5, 117.3 +/- 2.5 97.4 +/- 2 .9 vs 172.5 +/- 4.7, 163.8 +/- 7.9, 153.5 +/- 8.0 +/- mg/dl in patients wit h hepatocellular carcinoma (p<0.001). A significant increase of cholesterol (p<0.001) has been reported in the patients with liver cirrhosis when comp licated by hepatocellular carcinoma and it was not related to cholestasis. Conclusions. This observation seems to suggest that the enhanced cholestero l biosynthesis by tumoural cells leads to a rise in plasma cholesterol of p atients with cancer and, moreover that, this increase may be used as a neop lastic marker indicating the development of a tumour in patients with liver cirrhosis.