Transforming growth factor beta1 and soluble Fas serum levels in hepatocellular carcinoma.

In this study we assessed the usefulness of serum Transforming Growth Factor-beta1 (TGF-beta1) and soluble Fas (sFas) in distinguishing liver cirrhosis (LC) with and without hepatocellular carcinoma (HCC) as compared with alpha-fetoprotein (AFP). Serum TGF-beta1 and sFas levels were measured by ELISA in 51 LC patients, 54 patients with HCC and 30 healthy donors. Considering as a cut-off limit (mean+1SD of controls) 74 pg/ml and 637 pg/ml for TGF-beta1 and sFas, respectively, we computed serum concentrations of TGF-beta1 and sFas as a score (mean+/-SD). The positive frequency of serum TGF-beta1 levels in HCC patients (54%) was greater than in LC patients (26%) and healthy donors (3%). TGF-beta1 levels were higher in HCC (1.6+/-0.5) than in LC (1.1+/-0.2) (P<0.0001) and healthy donors (0.6+/-0.2). Using a cut-off limit of 82 pg/ml (mean+2SD), the positive frequency of TGF-beta1 was 20% in HCC patients. None of the controls and LC patients had TGF-beta1 levels higher than 82 pg/ml. The positive frequency of serum sFas levels was 100% in HCC patients, 98% in LC patients and 3% in healthy controls. Serum sFas levels were higher in HCC (2.5+/-0.7) than in LC (1.9+/-0.5) (P<0. 001) and healthy donors (0.6+/-0.3). No significant change of positive frequency was obtained by setting sFas cut-off at higher levels. sFas values did not correlate with TGF-beta1 levels. No relationship was found between TGF-beta1 amounts and AFP levels. However, in the 23% of HCC patients, with normal AFP values TGF-beta1 levels were higher than the cut off. These findings suggest the potential usefulness for TGF-beta1 assay in AFP-negative HCC.

[Cutaneous vasculitis, mixed cryoglobulinemia in a patient with non-secreting monolateral pheochromocytoma. A likely paraneoplastic syndrome]. / Vasculite cutanea, crioglobulinemia mista in un paziente con feocromocitoma monolaterale non secernente. Una probabile sindrome paraneoplastica.

We describe a patient who presented with purpuric lesions over his legs, asthenia and arthralgias. The patient was diagnosed as having cryoglobulinemia and no secreting monolateral pheochromocytoma. Two months after the removal of the tumour, the vasculitic lesions disappeared but the cryoglobulins were still present in the patient's serum. The cryoglobulins, which varied from 30 mg/dl to 60 mg/dl, persisted even during the following year. We consider this case noteworthy because the association among leukocytoclastic vasculitis, cryoglobulinemia and no secreting monolateral pheochromocytoma has not been previously described.