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Thus, patients with ascites or Child�CPugh C cirrhosis were FKBPL excluded to avoid confounding with ascites. Patients with cancer within the last 5 years, prior or current systemic chemotherapy, or previous liver transplant were also excluded. Patients with prior local therapy or resection were eligible as long as they had recurred and had measurable disease by Response Evaluation Criteria in Solid Tumors criteria. The protocol was approved by the Institutional Review Board at Columbia University Medical Center, and written informed consent was obtained from all subjects prior to enrollment. Data collection Patients were recruited in outpatient oncology and liver clinics. Upon enrollment, subjects completed an epidemiologic questionnaire and underwent a physical exam. Clinical data were obtained from the questionnaire and corroborated by the electronic medical record. Baseline fasting blood samples were drawn, including basic metabolic and hepatic panels, complete blood count, viral and autoimmune serologies, iron studies, ceruloplasmin, and alpha-1 antitrypsin to determine the etiology of liver disease. Other see more underlying causes of liver diseases were confirmed by clinical history and/or liver biopsies. Alcohol intake was considered significant for patients who were reported consuming two or more standard drinks per day (28?gm) for a year at any point in their lifetime. Diabetes mellitus was based on clinical history or enrollment fasting glucose level ��126?mg/dl. Survival data were obtained by using information from office visits, hospitalizations, or from the national social security death index. Tumor markers AFP and CA19-9 levels were obtained using the Associated Regional and University find more Pathologists, a national reference laboratory where Roche CA19-9 electrochemiluminescent immunoassay and Beckman Coulter Access DxI AFP assays were used. Clinical data such as tumor number, largest tumor diameter, and evidence of vascular invasion were obtained by evaluating pre-treatment imaging by one radiologist (SV). Pathological examination CA19-9 immunohistochemistry was performed on paraffin-embedded liver specimens from 10 and 12 randomly selected patients with elevated serum CA19-9 (��38?U/ml or median) and low serum CA19-9 (