Is There Any Association Between Blood Groups And Hepatocellular Carcinoma (HCC)?: A Preliminary Study
A Seham, A Nabeel, A Doaa, M Mohamed, T Ayman
A Seham, A Nabeel, A Doaa, M Mohamed, T Ayman. Is There Any Association Between Blood Groups And Hepatocellular Carcinoma (HCC)?: A Preliminary Study. The Internet Journal of Hematology. 2007 Volume 4 Number 2.
The study conducted on randomly selected 54 patients: 38 patients with hepatocellular carcinoma (HCC); 16 patients with cirrhosis and 10 healthy volunteers during the period of December 2001 to June 2002. 10 ml blood from each patient and control were collected. Each sample was divided into two parts: 1) 2 ml freshly used blood on ethylene – diamine – tetracetic acid (EDTA) as a preservative for testing the following blood group antigens by agglutination technique:
Hepatocellular carcinoma (HCC) is among the most common cancers in the world. It accounts for up to 85 % of primary liver cancers. The tumor is linked to environmental, dietary and lifestyle factors, so that its incidence and distribution vary widely among ethnic groups, geographical regions and sex (Gelatti
In 1990, more than 400,000 new cases of HCC became apparent worldwide, accounting for 5.4 % of all human cases of cancer and affecting men more than women (7.4 % and 3.2 %, respectively). In terms of relative frequency, HCC ranks as the fifth most common cancer in the world and the second most common cancer of the digestive tract, after cancer of the stomach (Sherman and Klein
The highest age incidence rates of HCC are in eastern Asia and central and western Africa where the incidence of HCC ranges from 22 to 35 / 100.000 men. A trend towards higher incidence rates of HCC has been documented in several developed countries, mainly as a result of increased population exposure to environmental risk factors and a decline in serious illnesses that compete with HCC as a cause of mortality (Colombo, 1999). The number of HCC cases has increased in the U.S. during the past two decades. The incidence raised from 1.4 / 100.000 persons during the period from 1976 to 1980 to 2.4 / 100.000 during the period from 1991 to 1995 with a shift in the incidence rate towards younger age groups (Camma
The annual incidence of HCC in patients with compensated cirrhosis is about 3 % and HCC has been identified as a relevant cause of death in these patients (Loof
Blood groups are one of the most conventional genetic markers of the blood. There are six red blood cells antigens systems named (ABO, Rh, MNSs, Kell, Duffy and Kidd). However, there are many other antigenic markers in human blood that stimulate the production of antibodies in recipients of blood transfusion (Calhoun and Petz, 2001).
Each blood group system is a series of red cell antigens, determined either by a single genetic locus or very closely linked loci. Alternative forms of genes coding for red cell antigens at a particular locus are called
Researches revealed relationship between blood groups and some diseases. Imai
The aim of the present work is to find out if there is any association between blood group antigens; [Major blood groups [ABO and RhD] and Minor blood groups [Rhd, MNSs, Duffy (Fy) and Lewis (Le)] and HCC patients.
Subjects & Methods
The study included randomly selected 54 patients admitted to Gastroenterology Surgery Center, Mansoura University, Mansoura, Egypt during the period of December 2001 to June 2002. The patients were: 38 patients with hepatocellular carcinoma (29 males & 9 females); 16 patients with cirrhosis (positive control group i.e. cirrhosis is an important underlying cause of HCC) (12 males & 4 females) and 10 healthy volunteers (negative controls) (7 males & 3 females). 10 ml blood from each patient and control were collected. Each sample was divided into two parts:
1) 2 ml freshly used blood on ethylene – diamine – tetracetic acid (EDTA) as preservative for testing the following blood group antigens by agglutination technique: Major blood groups [ABO and RhD] and Minor blood groups [Rhd, MNSs, Duffy (Fy) and Lewis (Le)]
2) The sera of the remaining blood samples (8 ml) were used to diagnose HCC patients: Two hepatitis markers: 1- p53 autoantibodies (p53 Abs) according to the method of Engvall and Perlman (1971)
The results were computed on IBM PC microprocessor by the statistical analysis program package, GraphPad Instat, copyright © 1990-1993 GraphPad Software, Version 2.03, USA. Data were presented as number and frequency (%). Comparisons between two independent groups were performed by the Mann-Whitney U test for two nonparametric tests. The Ranked-Spearman correlation test (r) was done to study the relation between the studied parameters. Values of p
Table (1) shows the phenotypes numbers and frequencies of
The correlation between blood groups and patients with HCC and cirrhosis is studied as shown in tables 2 & 3. The results reveal that, no significant correlation is found between any of the studied blood group systems and HCC or cirrhosis.
The correlation between blood groups and the two hepatitis markers (p53 & VEGF) are shown in tables 4 & 5. The results reveal that, no significant correlation is found between any of the studied blood group systems and VEGF and p53 markers except the significant correlation between M blood group and VEGF (p = 0.02).
The blood group antigens are stable characteristics controlled by genes inherited in a simple Mendelian manner (Huang
Also in (1989), Jovanovic
In addition, Wakabayashiet
Lin (1992), studied five monocolonal antibodies which recognized
The results of the present study are in contrast to the previous studies as there is no association was detected between any of the studied blood groups and HCC or cirrhosis. On the other hand, only association is detected between “M” blood group antigen and one of the studied HCC markers (VEGF) (p = 0.02). To our knowledge no other previous studies have shown any correlation between HCC marker (VEGF) and MN blood group.
On the other hand the results of the present study are in accordance to the results of the study of Neukirchen and Haase (1981). They found that there was no significant association between ABO blood group antigens in alcoholic patients and liver damage patients.
From the results of the present study and previous studies concerning the association between different blood groups and HCC, it can be concluded that no significant correlation was detected. These results suggested that no specific blood group could be considered as a risk factor for the occurrence of HCC in the studied patients. In the future more researches are required to be performed on larger number of patients in a trial to reach to a more statistical conclusive data.
It is recommended in the future studies to determine MN antigens in every patient with a history of liver disease especially the cirrhotic patients. Also, testing other minor blood groups as Kell