Elevated Serum Visfatin Levels Are Associated with Poor Prognosis of Hepatocellular Carcinoma

Visfatin is considered a pro-inflammatory adipocytokine, and it is commonly increased in obesity-related diseases. This study aimed to evaluate the levels of serum visfatin in patients with hepatocellular carcinoma (HCC) and its diagnostic and predictive value in detecting HCC. Fasting serum levels of visfatin of 135 HCC patients, 115 chronic hepatitis B (CHB) patients, 129 liver cirrhosis (LC) patients, and 149 healthy controls were determined via enzyme-linked immunosorbent assay. Meanwhile, serum alpha fetal protein (AFP) and interleukin-6 (IL-6) were also assayed. The median serum visfatin concentration in HCC patients was 1.113 ng/mL (range: 0.823-2.214 ng/mL), which was significant higher than those of healthy controls, CHB patients, and LC patients (P<0.05). The serum visfatin concentration in HCC patients was positively correlated with AFP (r=0.595, P<0.001) and IL-6 (r=0.261, P<0.015) and was also associated with tumor size and tumor node metastasis stage. Moreover, elevated levels of serum visfatin were associated with a higher HCC risk for CHB and LC patients. Multivariate Cox regression analysis had shown that HCC patients with high levels of serum visfatin had significantly shorter overall survival times than those with low serum visfatin levels (P<0.001). Using a cutoff visfatin level of 1.403 ng/mL, the receiver operating characteristic curve analysis showed unappealing sensitivity and specificity values (45.76% and 74.79%, respectively; AUC=0.626) regarding visfatin's use as a diagnostic marker for HCC. Our results indicate that increased serum visfatin levels are associated with poor prognosis of HCC. Visfatin may be a potential therapeutic target of HCC.