Risk factors for intraocular metastasis of primary liver cancer in diabetic patients: Alpha-fetoprotein and cancer antigen 125

doi:10.4239/wjd.v12.i2.158

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Feb 15, 2021 (publication date) through Feb 18, 2025

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World Journal of Diabetes

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1948-9358

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Study

World J Diabetes. Feb 15, 2021; 12(2): 158-169
Published online Feb 15, 2021. doi: 10.4239/wjd.v12.i2.158

Table 1 Clinical features of diabetic patients with primary liver cancer

Patient characteristics	IOM group (%)	NIOM group (%)	Total numbers of patients (%)	P value
Age (yr)¹	53.62 ± 8.61	58.66 ± 9.66		0.062
< 65	11 (84.6)	520 (73.3)	531 (73.5)
≥ 65	2 (15.4)	189 (26.7)	191 (26.5)
Gender²				0.777
Men	12 (92.3)	607 (85.6)	619 (85.7)
Women	1 (7.7)	102 (14.4)	103 (14.3)
Treatment²				0.015
Surgical resection	2 (15.4)	45 (6.3)	47 (6.5)
Chemotherapy	5 (38.5)	102 (14.4)	107 (14.8)
Other treatments	6 (46.2)	562 (79.3)	568 (78.7)
Histopathological type²				0.317
HCC	0	122 (17.2)	122 (16.9)
ICC	0	28 (3.9)	28 (3.9)
cHCC-ICC	0	2 (0.3)	2 (0.3)
Unclear	13 (100)	557 (78.6)	570 (78.9)
HbA1c	6.04 ± 0.54	6.23 ± 0.67	-	0.892

¹Indicates Student’s t-test was used.

²Indicates Chi-squared test was used. P < 0.05 represents statistical significance. IOM: Intraocular metastasis; NIOM: Non-intraocular metastasis; HCC: Hepatocellular carcinoma; ICC: Intrahepatic cholangiocarcinoma; cHCC-ICC: Combined hepatocellular carcinoma and intrahepatic cholangiocarcinoma.

Table 2 Differences in the concentration of various tumor biomarkers between patients with and without intraocular metastasis

Clinical features	IOM group	NIOM group	t	P value
AFP	1030.37 ± 342.38	526.37 ± 587.16	-5.17	< 0.001
CEA	6.54 ± 14.75	389.37 ± 10012.62	0.138	0.89
CA125	419.78 ± 356.43	148.03 ± 305.88	-3.165	0.002
CA199	200.35 ± 329.82	314.22 ± 4482.59	0.092	0.927
CA153	19.81 ± 15.06	20.32 ± 23.28	0.078	0.938
CA724	6.68 ± 8.44	6.91 ± 12.32	0.066	0.947
FER	198.23 ± 52.50	259.43 ± 224.57	0.981	0.327
ALP	192.54 ± 94.07	174.15 ± 171.39	-0.386	0.7
TC	4.75 ± 1.20	5.14 ± 8.62	0.161	0.872
TG	1.44 ± 0.81	1.37 ± 1.03	-0.257	0.797
HDL	1.30 ± 0.64	1.50 ± 1.17	0.602	0.548
LDL	2.52 ± 1.16	2.58 ± 1.43	0.144	0.885
ApoA1	1.65 ± 0.45	1.57 ± 0.87	-0.331	0.741
ApoB	0.77 ± 0.32	1.10 ± 0.82	1.426	0.154
Lp(a)	181.92 ± 219.72	221.66 ± 240.54	0.591	0.555
Ca	14.56 ± 44.90	2.14 ± 0.27	-0.997	0.338
Hb	114.69 ± 43.54	117.19 ± 22.31	0.207	0.84

P < 0.05 represents statistical significance. IOM: Intraocular metastasis; NIOM: Non-intraocular metastasis; AFP: Alpha-fetoprotein; CEA: Carcinoembryonic antigen; CA: Cancer antigen; FER: Ferritin; ALP: Alkaline phosphatase; TC: Total cholesterol; TG: Triglyceride; HDL: High density lipoprotein; LDL: Low density lipoprotein; ApoA1: Apolipoprotein A1; ApoB: Apolipoprotein B; Lp(a): Lipoprotein A; Ca: Calcium; Hb: Hemoglobin.

Table 3 The binary logistic regression results

Factors	B	OR	OR (95%CI)	P value
AFP	0.001	1.001	1.000-1.001	0.01
CA125	0.001	1.001	1.000-1.002	0.036

P < 0.05 represents statistical significance. B: Coefficient of regression; OR: Odds ratio; CI: Confidence interval; AFP: Alpha-fetoprotein; CA125: Cancer antigen 125.

Table 4 The receiver operating characteristic results of risk factors for predicting intraocular metastasis in diabetic liver cancer patients

	Cut-off value	Sensitivity (%)	Specificity (%)	AUC	95%CI	P value
AFP	994.20	0.923	0.599	0.727	0.627-0.827	0.005
CA125	120.23	0.846	0.701	0.796	0.678-0.915	< 0.001
AFP + CA125		0.769	0.893	0.860	0.745-0.975	< 0.001

P < 0.05 represents statistical significance. AUC: Area under the curve; CI: Confidence interval; AFP: Alpha-fetoprotein; CA125: Cancer antigen 125.

Table 5 Studies on the intraocular metastasis from different cancers

Ref.	Diseases with IOM
Tei et al[14], 2014	Rectal cancer
Shah et al[15], 2014	Lung cancer
Levison et al[16], 2018	Breast cancer
Chang et al[17], 2018	Esophageal carcinoma
Fountas et al[18], 2017	Thyroid cancer
Wu et al[19], 2019	Gastric carcinoma
Essadi et al[20], 2017	Renal cancer
Hazan et al[21], 2014	Choriocarcinoma

IOM: Intraocular metastasis.

Table 6 The risk factors for metastases from primary liver cancer

Ref.	Histopathological type	Metastatic sites	Risk factor
Lin et al[22], 2003	HCC	Lung	Tumor size
Ogawa et al[23], 2004	HCC	Distant metastasis	CD44v3
Xiang et al[24], 2009	HCC	Bone	CXCR4
Lin et al[25], 2010	HCC	Vessel	Aurora B
Kwak et al[26], 2012	HCC	Peritoneum	HCC rupture
Morimoto et al[27], 2014	HCC	EHM	Platelet, DCP
Chen et al[28], 2015	Small HCC	IHM and EHM	VEGF
Lee et al[29], 2019	HCC	EHM	AFP

HCC: Hepatocellular carcinoma; EHM: Extrahepatic metastasis; IHM: Intrahepatic metastasis; CD44v3: CD44 variant exon 3; CXCR4: CXC motif chemokine receptor 4; DCP: Des-γ-carboxyprothrombin; VEGF: Vascular endothelial growth factor; AFP: Alpha-fetoprotein.

Citation: Yu K, Tang J, Wu JL, Li B, Wu SN, Zhang MY, Li QY, Zhang LJ, Pan YC, Ge QM, Shu HY, Shao Y. Risk factors for intraocular metastasis of primary liver cancer in diabetic patients: Alpha-fetoprotein and cancer antigen 125. World J Diabetes 2021; 12(2): 158-169
URL: https://www.wjgnet.com/1948-9358/full/v12/i2/158.htm
DOI: https://dx.doi.org/10.4239/wjd.v12.i2.158