CIRCULATING, INTERCELLULAR-ADHESION MOLECULE-1 IN PATIENTS WITH HEPATOCELLULAR-CARCINOMA

Background: Intercellular adhesion molecule-1 (ICAM-1) is thought to p lay an important role in cellular immunological reactions. Expression can be induced by inflammatory cytokines in a wide variety of cells, i ncluding hepatocytes. Objective: To compare the behaviour of ICAM-1 in liver diseases. Patients and methods: We assayed serum ICAM-1 (sICAM- 1) in patients with hepatocellular carcinoma-associated liver cirrhosi s, and compared them with a group of cirrhotic patients and controls. sICAM-1 values were also correlated with some biochemical parameters o f liver function. Moreover, immunohistochemical localization of ICAM-1 was performed on liver tissue sections of patients with hepatocellula r carcinoma, liver cirrhosis and a sample of normal liver. Results: sI CAM-1 levels were significantly higher in the hepatocellular carcinoma patients than in controls (P<0.0001) and the cirrhosis group (P<0.001 ). sICAM-1 values directly correlated with alanine aminotransferase, t otal bilirubin, alkaline phosphatase and gamma-glutamyltranspeptidase serum values (P<0.05), with an inverse correlation with albuminaemia v alues (P<0.05). There was no correlation with alpha-fetoprotein values , but sICAM-1 values were higher in hepatocellular carcinoma patients with large tumours (>3 cm) than in those with small tumours (<3 cm) (P <0.04). Immunohistochemical localization of ICAM-1 was negative in nor mal liver tissue; positive staining for endothelial cells was found in chronic liver disease, while in hepatocellular carcinoma tissues, pos itive membrane staining was observed in hepatocytes and, to a lesser e xtent, at the cytoplasmic level. Conclusion: These results suggest tha t high serum levels of sICAM-1 are associated with severe liver diseas e, such as liver cirrhosis and hepatocellular carcinoma, and that they tend to increase with deteriorating hepatic function and tumour size.