Serum concentration of E-selectin in patients with chronic hepatitis, liver cirrhosis and hepatocellular carcinoma

Objectives: High levels of soluble E-selectin have been reported in acute a nd chronic inflammatory disorders, Moreover, in some types of tumor elevate d values have been found while in other types reduced levels have been repo rted. Our aims were to determine whether soluble E-selectin levels might be useful in monitoring the progression of chronic liver disease, including h epatocellular carcinoma. Methods: Circulating soluble E-selectin was measur ed by an enzyme-linked immunosorbent assay in the sera of 18 patients with chronic hepatitis, 44 with liver cirrhosis, and 38 with hepatocellular-carc inoma-associated liver cirrhosis. Immunohistochemical localization of E-sel ectin was also performed on liver tissue specimens of patients with chronic hepatitis, liver cirrhosis and hepatocellular carcinoma. Results: Serum le vels of soluble E-selectin were higher in the chronic hepatitis and liver c irrhosis patients than in the hepatocellular carcinoma patients and healthy controls. Levels in the hepatocellular carcinoma patients and controls wer e not significantly different. In the liver cirrhosis group, divided accord ing to the Child-Pugh classification, soluble E-selectin decreased with dis ease severity. Similarly, in patients with liver cirrhosis who developed he patocellular carcinoma, soluble E-selectin decreased as the disease progres sed. Immunohistochemical localization showed strong membrane staining on en dothelial cells in areas rich in inflammatory cells in severe chronic hepat itis. In some hepatocellular cat-cinema tissues a marked E-selectin stainin g was observed on endothelial cells of tumor-associated small vessels. Conc lusions: The results obtained suggest that high serum levels of soluble E-s electin are associated with chronic hepatitis and liver cirrhosis, and that levels decrease in liver cirrhosis patients as the disease progresses. Pat ients with hepatocellular carcinoma have different types of soluble E-selec tin behaviour the significance of which requires further investigation.