Clinical Significance of Annexin A4 as a Biomarker in the Early Diagnosis of Hepatocellular Carcinoma

Document Type : Research Articles


1 Endemic Medicine Department, Faculty of Medicine, Minia University, Minia, Egypt.

2 Clinical Pathology Department, Faculty of Medicine, Minia University, Minia, Egypt.


Background: Hepatocellular carcinoma (HCC) is one of the most prevalent cancer worldwide. Early detection of HCC is crucial to improve prognosis and survival. Nearly 30 % of HCC patients present with normal serum alpha fetoprotein (AFP), which highlights the need for new biomarkers for HCC. Annexin A4 (ANXA4) is one of the annexin family with high expressions found in gastric, liver, lung, colorectal and ovarian cancers. Aim : to evaluate the clinical significance of ANXA4 in the early diagnosis of HCC. Methods: Thirty patients with hepatitis C virus (HCV) related HCC were enrolled in this study. They were stage A according to Barcelona Clinic Liver Cancer (BCLC) staging and they were grade A or B according to Child Pugh Classification. Twenty patients with HCV-related liver cirrhosis and 20 healthy persons seronegative for both HCV and HBV served as control group. ANXA4 and AFP were measured in serum of all cases. Results: Serum ANXA4 level was significantly higher in HCC patients compared to patients with liver cirrhosis and healthy controls (188, IQR 42-428 and 23, IQR 24-33 and and 21, IQR 22-24 ng ̷ ml, respectively). By using the ROC curve, the area under the curve of ANXA4 was 0.972 and the best cut-off value was115 ng/ml, with sensitivity 95% and specificity 80%. Conclusion: The serum level of ANXA4 might be a good biomarker for the early detection of HCC.


Main Subjects

Volume 21, Issue 9
September 2020
Pages 2661-2665
  • Receive Date: 08 March 2020
  • Revise Date: 02 July 2020
  • Accept Date: 20 September 2020
  • First Publish Date: 20 September 2020