Serum Golgi protein 73 and glypican-3: early diagnostic biomarkers for hepatocellular carcinoma
Doaa F Gad1, Islam Eid Mohamed1, Essam Elmahdi1, Abdelnaser A Badawy2, Gamal Othman2, Mohamed G Dawoud3, Mohammed Diasty4, Maysaa E Zaki5, Mohamed M Abd El-Mawgod6
1 Department of Internal Medicine, Faculty of Medicine, Mansoura University, Mansoura, Egypt
2 Department of Medical Biochemistry, Faculty of Medicine, Mansoura University, Egypt
3 Department of General Surgery, Gastrointestinal Surgery Center, Faculty of Medicine, Mansoura University, Mansoura, Egypt
4 Department Tropical Medicine, Faculty of Medicine, Mansoura University, Mansoura, Egypt
5 Department of Clinical Pathology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
6 Department of Public Health and Community Medicine, Faculty of Medicine, Al-Azhar University, Assiut, Egypt
MD Essam Elmahdi
Department of Internal Medicine, Faculty of Medicine, Mansoura University, Mansoura
Source of Support: None, Conflict of Interest: None
Objectives The prognosis of hepatocellular carcinoma (HCC) is extremely worse, and chronic hepatitis C virus infection is one of the most important causes of HCC. The use of diagnostic serological markers in following up the high-risk individuals for developing HCC may help in its early detection and therapy. This study aimed to assess the effectiveness of serum Golgi protein 73 (GP73) and glypican-3 (GPC3) as new tumor biomarkers for early detection of HCC.
Patients and methods A case–control study included 125 patients infected with hepatitis C virus, comprising 60 with cirrhosis and 65 with HCC, in addition to 60 healthy individuals considered as the normal control group. Serum levels of GP73, GPC3, and alpha-fetoprotein (AFP) were assessed by enzyme-linked immunosorbent assay technique.
Result Serum GP73 and AFP levels were significantly higher in patients with HCC as compared with cirrhosis and control groups; however, their levels were significantly increased in patients with cirrhosis as compared with the healthy group (both P<0.001). However, GP73 was more sensitive than AFP in the diagnosis of HCC as the area under the receiver operating characteristic curve (area under the curve) with 95% confidence interval was 0.98 (0.95–1.0) for GP73 and 0.82 (0.74–0.90) for AFP. However, the area under the curve with 95% confidence interval for GPC3 was 0.44 (0.36–0.53). There was a significant association between AFP level and Barcelona clinic liver cancer staging of HCC (P=0.02). In addition, the serum level of GPC3 was higher in cirrhotic patients than other groups (P=0.007).
Conclusion Serum GP73 and not GPC3 can be used as early potential tumor biomarker for HCC diagnosis and also to differentiate HCC from cirrhosis.