Correlation between Serum Osteopontin and Different Stages of Hepatocellular Carcinoma

Abstract

Worldwide, there is a growing incidence of hepatocellular carcinoma (HCC). HCC represents more than 90% of primary liver cancers (Liovet et al., 2012). Egypt has the highest prevalence of HCV in the world and the prevalence of HCC is increasing in the last years. Alpha fetoprotein may be elevated in chronic liver disease, especially in viral hepatitis, in the absence of HCC. The relatively poor specificity of conventional alpha fetoproteins levels has led to a search for more sensitive and specific markers (El-Tayeh et al., 2012). Osteopontin (OPN) is a highly modified integrin-binding extra- cellular matrix glycophosphoprotein produced by cells of the immune system, epithelial tissue, smooth muscle cells, osteoblasts, and tumor cells. Extensive research has elucidated the pivotal role of OPN in cell signaling that controls inflammation, tumor progression, and metastasis (Fisher et al., 2001). OPN is reported to be overexpressed in many types of human malignant tumors including HCC and have been shown to participate in tumor invasion and the metastatic processes (Shijubo et al. 2000). The aim of this work was to evaluate the plasma level of osteopontin in patients with different stages of hepatocellular carcinoma to verify the possibility of using its level as a potential biomarker for progression of HCC. This cross sectional study was conducted in HCC clinic, Tropical Medicine Department, Faculty of Medicine, Ain Shams University Hospitals during the period from Jan 2015 to December 2015. The study was approved by the Investigation and Ethics Committee of the department. This study was conducted on 110 patients who had first given a written informed consent for study participation. Then they were divided into 4 groups, 3 groups of HCV related HCC, diagnosed & classified according to BCLC staging system 2010 and another group of chronic hepatitis C patients without HFL: • Group (1): 30 patients at stage A (early stage HCC). • Group (2): 30 patients at stage B (intermediate HCC). • Group (3): 30 patients at stage C&D (advanced & end stage HCC) • Group (4): (Control Group): 20 compensated chronic hepatitis C patients without hepatic focal lesion. Patients in all groups were subjected to full history taking, thorough clinical examination and laboratory investigations including (complete blood picture, ESR, liver function tests, kidney function, hepatitis viral markers, alfa fetoprotein and Osteopontin assay by ELISA kit), together with abdominal ultrasonography (US) and triphasic spiral computed tomography (CT). This study revealed that the overall mean age of all patients was (54.5+ 4.8) years, this study included 110 patients of whom 75 (68.5%) patients were males and 35 (31.8%) were females. Twenty eight (25.5%) patients suffered from DM while 82(74.5%) patients were non-diabetics. Thirty seven (33.6%) patients were hypertensive while 73(66.4%) patients were non-hypertensive. Twenty eight (25.5%) were active smokers, 4(3.6%) of them were on IV drugs and 38(34.5%) patients had a history of bilhariziasis. Eighteen patients (16.4%) underwent different operations, 7(6.4%) of them underwent dental procedures.