Clinicopathological and Prognostic Value of Plasma CD24 Level in Hepatocellular Carcinoma

Abstract

epatocellular carcinoma (HCC) is the sixth most common form of cancer worldwide and the second most common cause of cancer-related deaths. HCC often occurs in the background of a cirrhotic liver. There is an increased incidence of HCC due to the rise of Hepatitis B Virus, HCV infections and chronic alcohol use. Western’s HCC usually developed in cirrhotic liver while over 50% of Asian countries developed in noncirrhotic liver. More recent studies suggest metabolic syndrome, such as type II diabetes and obesity, is an additional risk factor for development of HCC. HCC diagnosis is based on imaging studies supported by measuring serum AFP levels. While these tools are effective for screening and diagnosis of HCC, their use for malignancy and recurrence detection is limited. It has been described that normal serum AFP levels postoperatively do not reflect total resection of HCC from the patient, and about 20% of HCC does not increase serum AFP levels. Additional markers such as GPC3, GGT II, AFU, TGF-β1, and TSGF may help improve accuracy but are not reliable by themselves. This brings in the need to find additional markers for postoperative detection and assessment of patient’s prognosis. one of them is CD24 Culster of Differentiation (CD24) is a small glycosylated mucin-like cell surface molecule. Many studies have found that CD24 expression is quite high in many human tumors. Under the pathological conditions, CD24 could mediate the tumor genesis, tumor progression and tumor metastasis. CD24-overex-pressing cancer cells are susceptible to the induction of epithelial-mesenchymal transition, a key step in enhancing cancer cells invasion and metastasis. In HCC cells, expression of CD24 has been correlated with accumulation of β-catenin leading to the activation of its oncogenic pathway