ELEVATION OF CIRCULATING IMMUNE-COMPLEXES AND ITS RELATIONSHIP TO ALPHA-FETOPROTEIN LEVELS IN PATIENTS WITH HEPATITIS-B SURFACE ANTIGEN-POSITIVE HEPATOCELLULAR-CARCINOMA

In an attempt to evaluate the relationship between circulating immune complexes (CIC) and alpha-fetoprotein (AFP), CIC and AFP were detected in 93 hepatitis B surface antigen-positive (HBsAg+) patients with hepatocellular carcinoma (HCC) and 54 healthy controls. The median level of 3% PEG (polyethylene glycol)-CIC and C1q-CIC were higher in patients than in controls (p < 0.001). In patients with HCC, the prevalence of elevated 3% PEG-CIC, C1q-CIC, and AFT was 27.9%, 55.9%, and 77.4%, respectively. There was association between AFP and 3% PEG-CIC positivity (p < 0.01). The median level of 3% PEG-CIC and C1q-CIC increased as AFP levels elevated (p < 0.05), but decreased as AFP exceeded 1599 ng/ml (p < 0.05). For adjusting the effect of impaired liver function on the level of CIC, multivariate analysis with stepwise logistic regression revealed that 3% PEG-CIC was associated, in a dose-related fashion, with an increased risk for developing HCC (odds ratio = 1.003, p < 0.001). These results imply that elevation of 3% PEG-CIC may be related to tumor mass. Additionally, 3% PEG-CIC is a useful marker to monitor therapy with transcatheter arterial embolization in patients with HBsAg+ HCC.