A study about mechanisms of des-gamma-carboxy prothrombin's production in hepatocellular carcinoma.

Abstract

AIM:

Des-gamma-carboxy prothrombin (DCP) is an abnormal prothrombin, increased in serum of patients with hepatocellular carcinoma (HCC) as result of an acquired defect of post-translational carboxylation of prothrombin's precursor. It is unclear if the reduced activity of gamma-carboxylase is secondary to vitamin K deficiency or to an altered gene encoding this enzyme. The aim of this study was to evaluate the effect of vitamin K administration on DCP and alpha-fetoprotein (AFP) levels, to identify a relationship between vitamin K and DCP serum levels and to investigate mechanisms of serum elevation of DCP levels.

METHODS:

The authors determined DCP and AFP serum levels and vitamin K concentration in 64 cirrhotics with HCC and in 60 cirrhotic subjects without HCC. In HCC subjects DCP and AFP levels were measured before and after vitamin K administration. A t-test for unpaired data was applied (P values <0.05 statistically significant).

RESULTS:

Only HCC patients had detectable levels of DCP and significant AFP levels. Administration of vitamin K reduced DCP but not AFP levels in HCC patients. No correlation was observed between vitamin K concentration and DCP levels: vitamin K concentration was similar both in HCC patients and in control group without HCC; HCC patients had the same vitamin K concentration regardless of elevated o reduced DCP levels after vitamin K administration.

CONCLUSION:

DCP detectable serum levels are the result not only of vitamin K deficiency or selective defects of carboxylase, because probably alterations of membrane receptors or cytoplasmatic transfers, that are necessary for the function of vitamin K, are involved.

• Authors: G Bertino, A M Ardiri, P M Boemi, D Ierna, D Interlandi, L Caruso, E Minona, M A Trovato, S Vicari, G Li Destri, S Puleo
• Journal: Panminerva medica (Panminerva Med) Vol. 50 Issue 3 Pg. 221-6 (Sep 2008) ISSN: 0031-0808 [Print] Italy
• PMID: 18927526 (Publication Type: Journal Article)

Chemical References

• AFP protein, human
• Biomarkers
• Protein Precursors
• alpha-Fetoproteins
• Vitamin K
• acarboxyprothrombin
• Vitamin K 1
• Prothrombin

Topics

• Aged
• Biomarkers (blood)
• Carcinoma, Hepatocellular (blood)
• Case-Control Studies
• Female
• Humans
• Injections, Intravenous
• Liver Neoplasms (blood)
• Male
• Middle Aged
• Protein Precursors (blood)
• Prothrombin
• Up-Regulation
• Vitamin K (blood)
• Vitamin K 1 (administration & dosage)
• Vitamin K Deficiency (blood)
• alpha-Fetoproteins (metabolism)