A new diagnostic biomarker in early detection of Hepatocellular Carcinoma

Batchimeg B; Baljinnyam T; Khulan U; Khaliun M; Bilguun E; Munkhtsetseg B; Terguunbileg B; Chinzorig M; Gan-erdene B; Bilegtsaikhan Ts; Erkhembulgan P; Batbold B; Munkhbat B; Munkhtuvshin N; Munkhbayar S

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A new diagnostic biomarker in early detection of Hepatocellular Carcinoma

VernacularTitle:Элэгний хавдрын эрт илрүүлгийн шинэ биомаркерийн судалгаа
Author: Batchimeg B ¹ ; Baljinnyam T ¹ ; Khulan U ¹ ; Khaliun M ¹ ; Bilguun E ¹ ; Munkhtsetseg B ¹ ; Terguunbileg B ² ; Chinzorig M ² ; Gan-Erdene B ³ ; Bilegtsaikhan Ts ³ ; Erkhembulgan P ¹ ; Batbold B ¹ ; Munkhbat B ⁴ ; Munkhtuvshin N ¹ ; Munkhbayar S ¹
Author Information

1. Institute of Medical Sciences, MNUMS
2. National Cancer Center of Mongolia
3. Second State Central Hospital, Mongolia
4. Mongolian National University of Medical Sciences
Publication Type:Journal Article
Keywords: Hepatocellular carcinoma; Alpha-fetoprotein; Glypican-3 serum; Biomarkers
From:Mongolian Medical Sciences 2021;197(3):10-16
CountryMongolia
Language:Mongolian
Abstract: Background and Aims:Hepatocellular carcinoma (HCC) is a common cause of cancer related death in Mongolia. Early diagnosis is the very important management to increase successful treatment and survival rate. Glypican-3 (GPC3) protein is highly expressed in hepatocellular carcinoma (HCC) tissue and in serum of HCC patients. Recent studies have been conducted and suggested as a diagnostic biomarker for detecting HCC in the early stage. Therefore, we investigated the diagnostic value of the serum GPC3 level and compared it to the alpha-fetoprotein (AFP) level as a diagnostic biomarker of HCC.
Methods:We enrolled a total of 90 participants and divided into 3 groups with HCC (30), with liver cirrhosis (LC/30) and healthy (30) as the control group (30). GPC3 and AFP serum (sGPC-3, sAFP) levels were measured using commercially available enzyme-linked immunosorbent assay kits. The diagnostic accuracy was analyzed using the receiver operating characteristics (ROC) curve and estimated sensitivity and specificity of each biomarker.
Results:sGPC3 was significantly elevated in the HCC group as compared to liver cirrhosis and healthy subjects (658±138.2 pg/ml, 378±25.5 pg/ml, 356.3±29 pg/ml) respectively. sGPC-3 sensitivity was 96.6% and specificity was 100%. The area under the ROC curve (AUC) for GPC3 was 0.999 (0.996- 1.0).
In comparison, the mean of AFP was significantly higher in HCC (16.9±11.7 ng/ml) than in LC (6.7±7.6 ng/ml) and in healthy subject (3.3±2.1 ng/ml) and AFP sensitivity was 43,3 %, specificity was 95 % with an AUC of 0.808 (0.696- 0.921).
The combination of GPC-3 with AFP achieved the highest sensitivity (97.1%) and specificity (97%).
Conclusion:Serum GPC3 has a higher sensitivity than AFP for the early diagnosis of HCC. Combination of two markers showed greatest diagnostic accuracy.
Full text:2021-197(3)-10-16.pdf