Role of Albumin in Growth Inhibition in Hepatocellular Carcinoma

Objective: Levels of serum albumin have recently emerged, together with C-reactive protein, as an important prognostic indicator for hepatocellular carcinoma (HCC). It has recently been reported that larger HCCs are associated with lower albumin levels. However, the albumin-mediated growth decrease has yet to be determined. Methods: We examined a large HCC cohort and then by direct exposure of HCC cells in vitro, the relationship of albumin levels to HCC growth. Results: We found that patients with lower albumin levels had significantly larger maximum tumor diameters, more portal vein thrombosis, more tumor multifocality, higher a-fetoprotein levels, and a lower survival than patients with higher albumin levels. Direct addition of exogenous albumin at physiological concentrations resulted in decreased growth in several HCC cell lines in vitro. We found a decrease in MAP kinase levels and in levels of Cdk2 and Cdk4, cyclinE, as well as in a-fetoprotein. Conclusion: These results indicate that in addition to its role as a moni-tor of systemic inflammation, albumin may have a direct role in HCC growth inhibition, either through modulation of a-fetoprotein or through its actions on growth-controlling kinases. (C) 2017 S. Karger AG, Basel