{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T17:04:44Z","timestamp":1790528684951,"version":"4.1.0"},"reference-count":27,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2013,7,22]],"date-time":"2013-07-22T00:00:00Z","timestamp":1374451200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"crossref","award":["KAKENHI 23590976"],"award-info":[{"award-number":["KAKENHI 23590976"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2013,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aim<\/jats:title><jats:p>Follistatin (<jats:styled-content style=\"fixed-case\">FST<\/jats:styled-content>) is a glycoprotein expressed in most organs, which interacts with activins or other members of the transforming growth factor beta family. Recently, several reports have shown that <jats:styled-content style=\"fixed-case\">FST<\/jats:styled-content> regulates a variety of processes during tumor progression. Here, serum <jats:styled-content style=\"fixed-case\">FST<\/jats:styled-content> in patients with liver diseases was measured, and its clinical utility as a biomarker was assessed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Serum was collected from 162 patients (91 hepatocellular carcinoma [<jats:styled-content style=\"fixed-case\">HCC<\/jats:styled-content>], 43 liver cirrhosis, and 28 chronic hepatitis) as well as from 16 healthy volunteers. <jats:styled-content style=\"fixed-case\">FST<\/jats:styled-content> was quantified by enzyme\u2010linked immunosorbent assays, and levels were compared with clinical parameters including survival of the <jats:styled-content style=\"fixed-case\">HCC<\/jats:styled-content> patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Median serum <jats:styled-content style=\"fixed-case\">FST<\/jats:styled-content> levels in <jats:styled-content style=\"fixed-case\">HCC<\/jats:styled-content>, liver cirrhosis, chronic hepatitis, and healthy volunteers were 1168, 1606, 1324, and 1661\u2009pg\/m<jats:styled-content style=\"fixed-case\">L<\/jats:styled-content>, respectively, not significantly different. In <jats:styled-content style=\"fixed-case\">HCC<\/jats:styled-content> patients, higher serum <jats:styled-content style=\"fixed-case\">FST<\/jats:styled-content> was associated with greater age, hepatitis <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content> virus antibody\u2010negativity, large tumor size, g\u2010glutamyl transpeptidase, des\u2010gamma carboxyprothrombin and presence of portal vein tumor thrombus. Survival of <jats:styled-content style=\"fixed-case\">HCC<\/jats:styled-content> patients with high <jats:styled-content style=\"fixed-case\">FST<\/jats:styled-content> levels was significantly shorter than for those with low levels (<jats:italic>P<\/jats:italic>\u2009=\u20090.004). Multivariate analysis revealed that in addition to large tumor size and presence of portal vein thrombus, high <jats:styled-content style=\"fixed-case\">FST<\/jats:styled-content> levels were independently correlated with poor prognosis (hazard ratio\u2009=\u20092.41, 95% confidence interval\u2009=\u20091.16\u20135.00, <jats:italic>P<\/jats:italic>\u2009=\u20090.02).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Serum <jats:styled-content style=\"fixed-case\">FST<\/jats:styled-content> levels are significantly associated with <jats:styled-content style=\"fixed-case\">HCC<\/jats:styled-content> prognosis and could represent a predictive biomarker in this disease.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jgh.12167","type":"journal-article","created":{"date-parts":[[2013,2,22]],"date-time":"2013-02-22T16:10:18Z","timestamp":1361549418000},"page":"1391-1396","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Prognotic impact of serum follistatin in patients with hepatocellular carcinoma"],"prefix":"10.1111","volume":"28","author":[{"given":"Takeshi","family":"Tomoda","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences  Okayama City Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuhiro","family":"Nouso","sequence":"additional","affiliation":[{"name":"Department of Molecular Hepatology Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences  Okayama City Okayama 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