Serum Biomarkers for Early Detection of Hepatocellular Carcinoma Associated with HCV Infection in Egyptian Patients

Background: Early detection of hepatocellular carcinoma using serological markers with better sensitivityand specificity than alpha fetoprotein (AFP) is needed. Aims: The aim of this study was to evaluate the diagnosticvalue of serum sICAM-1, β-catenin, IL-8, proteasome and sTNFR-II in early detection of HCC. Materials and
Methods: Serum levels of IL-8, sICAM-1, sTNFR-II, proteasome and β-catenin were measured by ELISA assayin 479 serum samples from 192 patients with HCC, 96 patients with liver cirrhosis (LC), 96 patients with chronichepatitis C (CHC) and 95 healthy controls.
Results: Serum levels of proteasome, sICAM-1, β-catenin and αFPwere significantly elevated in HCC group compared to other groups (P-value<0.001), where serum level of IL-8was significantly elevated in the LC and HCC groups compared to CHC and control groups (P-value <0.001),while no significant difference was noticed in patients with HCC and LC (P-value=0.09). Serum level of sTNFRIIwas significantly elevated in patients with LC compared to HCC, CHC and control groups (P-value <0.001);also it was significantly higher in HCC compared to CHC and control groups (P-value <0.001). ROC curveanalysis of the studied markers between HCC and other groups revealed that the serum level of proteasome hadsensitivity of 75.9% and specificity of 73.4% at a cut-off value of 0.32 μg/ml with AUC 0.803 sICAM-1 at cutoff value of 778ng/ml, the sensitivity was 75.8% and the specificity was 71.8% with AUC 0.776. β-catenin hadsensitivity and specificity of 70% and 68.6% respectively at a cut off value of 8.75ng/ml with an AUC of 0.729.sTNFR-II showed sensitivity of 86.3% and specificity of 51.8% at a cut off value of 6239.5pg/ml with an AUCof 0.722. IL-8 had sensitivity of 70.4% and specificity of 52.3% at a cut off value of 51.5pg/ml with AUC 0.631.
Conclusions: Our data supported the role of proteasome, sICAM-1, sTNFR-II and β-catenin in early detectionof HCC. Also, using this panel of serological markers in combination with αFP may offer improved diagnosticperformance over αFP alone in the early detection of HCC.