High plasma concentrations of endothelin-like immunoreactivities in patients with hepatocellular carcinoma

The plasma levels of endothelin-like immunoreactivities (ET-IR) of patients with hepatocellular carcinoma (HCC) were compared with those of patients with liver cirrhosis (LC), using a specific radioimmunoassay for endothelin-1. The mean concentration of plasma ET-IR of 21 HCC patients (30.3 +/- 8.5 pg/ml, n = 21) (means +/- SD) was markedly higher than those in LC (22.1 +/- 4.7 pg/ml, n = 16) (p < 0.01), which were also elevated compared with those in normal subjects (9.4 +/- 1.6 pg/ml, n = 91). Moreover, the level of plasma ET-IR reflected the tumor size of HCC patients, which was estimated by the ultrasonic and computed tomographic examinations. Although there was no relation to other biochemical parameters indicating liver function or tumor markers such as alpha-fetoprotein, a good positive correlation was obtained between plasma ET-IR and C-reactive protein (CRP) concentrations of HCC patients (r = 0.805, p < 0.01). We measured the tissue contents of ET-IR in HCC and its adjacent LC tissue, but failed to find any significant difference between the mean content of HCC (0.50 +/- 0.38 ng/g) and LC (0.44 +/- 0.28 ng/g). The endothelial cell damage due to cancer growth may not be responsible for the high concentrations of plasma ET-IR of HCC, because plasma thrombomodulin concentrations were not correlated with plasma ET-IR levels in HCC patients. Our study implies that the high plasma concentration of ET-IR is pathogenomonic to HCC, although the site of production is still debatable.