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Quantitation of tissue polypeptide antigen (TPA) in hepatic and systemic circulation in patients with chronic liver diseases
Author(s) -
Puoti Claudio,
Bellis Lia,
Guarisco Riccardo,
Costanza Olga Mitidieri,
Felici Renata,
Spilabotti Lucia,
Paglia Federica,
Galossi Alessandra,
Dell' Unto Orlando
Publication year - 2009
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.2009.05916.x
Subject(s) - medicine , cirrhosis , portal venous pressure , gastroenterology , portal hypertension , hyperdynamic circulation , chronic liver disease , vein , pathology
Background and Aim: Abnormal serum tissue polypeptide antigen (TPA) values are commonly found in patients with chronic liver damage and liver cirrhosis even in the absence of malignancies. The aim of this study was to compare serum TPA levels in patients with cirrhosis, to examine correlations between TPA levels and the degree of portal hypertension, and to evaluate TPA concentrations in paired hepatic and peripheral blood samples. Methods: A total of 128 patients with chronic liver disease of various severity were studied prospectively. TPA concentrations in hepatic vein and peripheral blood were determined, and Hepatic Vein Pressure Gradient (HVPG) was measured. Results: TPA levels were significantly higher in patients with cirrhosis than in those with chronic hepatitis, and in systemic circulation than in hepatic vein blood. Peripheral but not hepatic TPA levels did correlate with the HVPG. Subjects with clinically significant portal hypertension (HVPG > 10 mmHg) showed significantly higher peripheral TPA levels than those with HVPG < 10 mmHg. Conclusions: Our data suggest that the increased TPA levels observed in cirrhotic patients and the high systemic‐to‐hepatic blood TPA gradient are probably due to the presence of portal‐systemic shunts rather than to hepatic necro‐inflammatory activity. In clinical practice, TPA determination could help us to identify and to follow up cirrhotic patients with more severe portal hypertension.