Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Feb 15, 2021; 12(2): 158-169
Published online Feb 15, 2021. doi: 10.4239/wjd.v12.i2.158
Risk factors for intraocular metastasis of primary liver cancer in diabetic patients: Alpha-fetoprotein and cancer antigen 125
Kang Yu, Jing Tang, Jie-Li Wu, Biao Li, Shi-Nan Wu, Meng-Yao Zhang, Qiu-Yu Li, Li-Juan Zhang, Yi-Cong Pan, Qian-Min Ge, Hui-Ye Shu, Yi Shao
Kang Yu, Biao Li, Shi-Nan Wu, Meng-Yao Zhang, Qiu-Yu Li, Li-Juan Zhang, Yi-Cong Pan, Qian-Min Ge, Hui-Ye Shu, Yi Shao, Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China
Jing Tang, Department of Oncology, The Affiliated Zhuzhou Hospital Xiangya Medical College, Central South University, Zhuzhou 412000, Hunan Province, China
Jie-Li Wu, Department of Ophthalmology, Xiang’an Hospital of Xiamen University, Xiamen 361102, Fujian Province, China
Author contributions: Shao Y obtained funding support; Yu K, Tang J and Shao Y contributed to study design; Yu K, Tang J, Shao Y and Zhang MY contributed to data collection; Wu JL and Zhang LJ performed data interpretation; Yu K, Tang J, Wu JL, Li B, Pan YC and Ge QM performed the statistical analysis; Yu K, Tang J, Wu SN, Li QY and Shu HY conducted the literature search; Yu K and Shao Y prepared the manuscript.
Supported by The National Natural Science Foundation of China, No. 81400372 and 81660158; the Key Research and Development Plan of Jiangxi Province, No. 20181BBG70004; the Young Scientists Fund of Jiangxi Province, No. 20161ACB21017 and 20151BAB215016; the Science and Technology Plan Project of Jiangxi Province, No. 20151BBG70223; and the Distinguished Young Scientists Fund of Jiangxi Province, No. 20192BCBL23020.
Institutional review board statement: This study was reviewed and approved by the Medical Ethics Committee of the First Affiliated Hospital of Nanchang University.
Informed consent statement: Informed consent was obtained from the patients included in this study.
Conflict-of-interest statement: This was not an industry supported study. The authors report no conflicts of interest in this work.
Data sharing statement: The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yi Shao, MD, PhD, Director, Doctor, Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, No. 17 Yongwaizheng Street, Donghu District, Nanchang 330006, Jiangxi Province, China. freebee99@163.com
Received: October 8, 2020
Peer-review started: October 8, 2020
First decision: November 18, 2020
Revised: November 26, 2020
Accepted: December 11, 2020
Article in press: December 11, 2020
Published online: February 15, 2021
Processing time: 106 Days and 16.5 Hours
Abstract
BACKGROUND

In rare instances, primary liver cancer can be associated with intraocular metastasis (IOM).

AIM

To investigate the correlation between a diverse range of clinical characteristics and IOM in diabetic patients with primary liver cancer, and to determine potential risk factors in predicting IOM.

METHODS

We recruited a total of 722 diabetic patients with primary liver cancer. The differences between the IOM and non-intraocular metastasis (NIOM) groups in these patients were assessed using the chi-squared test and Student’s t-test. Binary logistic regression analysis was subsequently used to determine risk factors. Finally, the diagnostic value of IOM in this cohort with primary liver cancer was analyzed by receiver operating characteristic (ROC) curve analysis.

RESULTS

In all, 13 patients had IOM. There were no remarkable intergroup differences with respect to age, sex, histopathological sub-types, or blood biochemical parameters. However, the IOM group had significantly higher alpha-fetoprotein (AFP) and cancer antigen 125 (CA125) values than the NIOM group. Binary logistic regression identified AFP and CA125 to be significant risk factors for IOM in diabetic patients with primary liver cancer. ROC curve analysis showed that the area under the curve values for AFP and CA125 were 0.727 and 0.796, with the cut-off values of 994.20 ng/mL and 120.23 U/mL, respectively. The sensitivity and specificity for AFP were 92.3% and 59.9%, while those for CA125 were 84.6% and 70.1%, respectively.

CONCLUSION

Elevated AFP and CA125 represent significant risk factors for IOM in diabetic patients with primary liver cancer.

Keywords: Primary liver cancer; Intraocular metastasis; Diabetes; Alpha-fetoprotein; Cancer antigen 125; Risk factors

Core Tip: This is a retrospective study designed to evaluate the risk factors for ocular metastasis in patients with diabetic primary liver cancer. Elevated alpha-fetoprotein (AFP) and cancer antigen 125 (CA125) represent significant risk factors for intraocular metastasis (IOM) in diabetic patients with primary liver cancer. Notably, the combination of AFP and CA125 is more reliable for differentiation between IOM and non-intraocular metastasis in diabetic patients with primary liver cancer.