AIM: The utility of serum alpha-fetoprotein (α-FP) for the detection of hepatocellular carcinoma (HCC) is questionable.High serum levels of chromogranin-A (CgA) have recently been reported in HCC. Impaired hepatic, r...AIM: The utility of serum alpha-fetoprotein (α-FP) for the detection of hepatocellular carcinoma (HCC) is questionable.High serum levels of chromogranin-A (CgA) have recently been reported in HCC. Impaired hepatic, renal, and heart functions influence circulating CgA. The aim of this study was to assess sensitivity and specificity of serum CgA as a marker of HCC in patients with liver cirrhosis (LC).METHODS: Serum CgA levels were measured by RIA in 339 patients of which 54 HCC, 132 LC, 45 chronic hepatitis (CH), 27 chronic heart failure (CHF), 36 chronic renal failure (CRF), 45 chronic inflammatory bowel disease (IBD)as disease controls and in 75 healthy controls. Patients with liver disease or IBD and concomitant renal and/or heart failure were excluded. Pearson correlation, nonparametric combination test and confidence interval analysis were used for statistical analysis.RESULTS: Serum CgA above normal values (100 ng/mL)were found in 83% of HCC patients, in 48% of LC patients,in 20% of CH patients, in 33% of IBD patients, in 92% of CRF patients, in 100% of CHF patients, and in none of the healthy controls. The mean CgA values in HCC (769±1 046), in LC (249±369), in CH (87±94), in CRF (1 390±1 401), in CHF (577±539), in IBD (146±287) were significantly higher than those in healthy controls (48±18).HCC patients had higher CgA values (P＜0.01) than LC,CH, and IBD patients but did not differ from those with CRF or CHF. The 95% CI for the mean (250-1 289 ng/mL)in HCC patients was selected as a CgA range and the lower value of such range was assumed as cut-off.Sensitivity and specificity of CgA, calculated in relation to the cut-off in patients with cirrhosis and HCC, were respectively 61% (CI 48-73%) and 82% (CI 75-88%).Serum α-FP values were ＞200 ng/mL in 21% of the HCC patients and in none of the LC patients. No significant correlation was found between α-FP and CgA in patients with HCC and in patients with cirrhosis.CONCLUSION: When HCC is suspected and α-FP is normal or ＜200 ng/mL, CgA serum values represent a complementary diagnostic tool, unless kidney or heart failure is present.展开更多
The roles of dietary fibers and nutraceuticals for primary prevention of cardiovascular disease from childhood are reviewed. Nutrition as an epigenetic modifier and the roles of endothelium, risk factors, epidemiologi...The roles of dietary fibers and nutraceuticals for primary prevention of cardiovascular disease from childhood are reviewed. Nutrition as an epigenetic modifier and the roles of endothelium, risk factors, epidemiological evidence and Mediterranean diet are critically analysed. Overfeeding in childhood can lead to the development of obesity and/or atherosclerosis in adult life. In particular, a high intake of nutrients affects the in utero programming with the adverse consequences of insulin resistance an endothelial dysfunction that lead to early atherosclerosis. Dietary fibers have important health benefits in childhood and research suggests that they may prevent obesity and lower blood cholesterol levels with a favourable impact on the risk of future cardiovascular disease incidence. However, it is for further studies to assess whether also in Southern European Countries, practicing Mediterranean diet as a normal habit, dietary fibers may contribute to modify the relatively low proportion of hyperlipemia observed in our population.展开更多
文摘AIM: The utility of serum alpha-fetoprotein (α-FP) for the detection of hepatocellular carcinoma (HCC) is questionable.High serum levels of chromogranin-A (CgA) have recently been reported in HCC. Impaired hepatic, renal, and heart functions influence circulating CgA. The aim of this study was to assess sensitivity and specificity of serum CgA as a marker of HCC in patients with liver cirrhosis (LC).METHODS: Serum CgA levels were measured by RIA in 339 patients of which 54 HCC, 132 LC, 45 chronic hepatitis (CH), 27 chronic heart failure (CHF), 36 chronic renal failure (CRF), 45 chronic inflammatory bowel disease (IBD)as disease controls and in 75 healthy controls. Patients with liver disease or IBD and concomitant renal and/or heart failure were excluded. Pearson correlation, nonparametric combination test and confidence interval analysis were used for statistical analysis.RESULTS: Serum CgA above normal values (100 ng/mL)were found in 83% of HCC patients, in 48% of LC patients,in 20% of CH patients, in 33% of IBD patients, in 92% of CRF patients, in 100% of CHF patients, and in none of the healthy controls. The mean CgA values in HCC (769±1 046), in LC (249±369), in CH (87±94), in CRF (1 390±1 401), in CHF (577±539), in IBD (146±287) were significantly higher than those in healthy controls (48±18).HCC patients had higher CgA values (P＜0.01) than LC,CH, and IBD patients but did not differ from those with CRF or CHF. The 95% CI for the mean (250-1 289 ng/mL)in HCC patients was selected as a CgA range and the lower value of such range was assumed as cut-off.Sensitivity and specificity of CgA, calculated in relation to the cut-off in patients with cirrhosis and HCC, were respectively 61% (CI 48-73%) and 82% (CI 75-88%).Serum α-FP values were ＞200 ng/mL in 21% of the HCC patients and in none of the LC patients. No significant correlation was found between α-FP and CgA in patients with HCC and in patients with cirrhosis.CONCLUSION: When HCC is suspected and α-FP is normal or ＜200 ng/mL, CgA serum values represent a complementary diagnostic tool, unless kidney or heart failure is present.
文摘The roles of dietary fibers and nutraceuticals for primary prevention of cardiovascular disease from childhood are reviewed. Nutrition as an epigenetic modifier and the roles of endothelium, risk factors, epidemiological evidence and Mediterranean diet are critically analysed. Overfeeding in childhood can lead to the development of obesity and/or atherosclerosis in adult life. In particular, a high intake of nutrients affects the in utero programming with the adverse consequences of insulin resistance an endothelial dysfunction that lead to early atherosclerosis. Dietary fibers have important health benefits in childhood and research suggests that they may prevent obesity and lower blood cholesterol levels with a favourable impact on the risk of future cardiovascular disease incidence. However, it is for further studies to assess whether also in Southern European Countries, practicing Mediterranean diet as a normal habit, dietary fibers may contribute to modify the relatively low proportion of hyperlipemia observed in our population.
