Evaluation of Serum Endoglin Level as a New Diagnostic Biomarker for Hepatocellular Carcinoma
Mohamed Gamal Tawfik Talkhan;
Abstract
Hepatocellular carcinoma is one of the most common malignancies worldwide and the most common primary malignant tumor of the liver. It is the second leading cause of cancer related deaths in the world. It occurs most commonly on top of a cirrhotic liver which in Egypt is prevalence is due to chronic HCV infection.
Diagnosis of HCC at earlier stages improves patient outcomes. Currently, the most commonly used methods for screening and diagnosing HCC are ultrasound imaging and serum α-fetoprotein (AFP) concentration measurements, but the diagnostic value of AFP is recently challenged due to its low sensitivity and specificity.
The aim of this study was to determine the diagnostic value of Endoglin as a biomarker for HCC in patients with liver cirrhosis.
The study was conducted upon 90 subjects who were divided into three groups: group I included 40 patients with liver cirrhosis and hepatocellular carcinoma, group II included 30 patients with liver cirrhosis without HCC, group III had 20 healthy subjects as controls. Group I was also divided into 2 subgroups, Group Ia represents patients with AFP less than 200ng/ml and Group Ib represents patients with AFP more than 200ng/ml.
In this study the age of patients in group I was higher than the other two groups with no statistically significant difference. Male: Female ratio was high in all the 3 groups with no statistically significant difference.
Regarding alpha fetoprotein its serum levels were much higher in the HCC group compared to the other two with statically significant difference.
In this study, the serum levels of Endoglin were highest in patients of group I with HCC compared to those with liver cirrhosis and the control groups with significant difference.
Serum Endoglin level was positively correlated to AFP and negatively correlated to all other patient’s parameters and laboratory data including :age, gender , smoking status , performance state , Child-Pugh score , MELD new score , BCLC staging , CBC , renal function tests and liver function tests.
Serum AFP was found to be positively correlated with number of hepatic focal lesions. However, it did not increase significantly with tumour size, vascular invasion.
Also Endoglin values was found to be positively correlated with tumor number, but not with tumor size, vascular invasion.
At a cut off value 220ng/ml, the diagnostic sensitivity and specificity of AFP for selective detection of HCC over the cirrhotic group was 67.5% and 100% respectively.
At a cut off value 1125pg/ml the diagnostic sensitivity and specificity of Endoglin for selective detection of HCC over the cirrhotic group was 90% and 76.67% respectively.
When combining both markers together the sensitivity increased to 100% with a specificity of 100%.
In conclusion, Endoglin can be used as a biomarker for hepatocellular carcinoma with a good diagnostic and prognostic value.
Diagnosis of HCC at earlier stages improves patient outcomes. Currently, the most commonly used methods for screening and diagnosing HCC are ultrasound imaging and serum α-fetoprotein (AFP) concentration measurements, but the diagnostic value of AFP is recently challenged due to its low sensitivity and specificity.
The aim of this study was to determine the diagnostic value of Endoglin as a biomarker for HCC in patients with liver cirrhosis.
The study was conducted upon 90 subjects who were divided into three groups: group I included 40 patients with liver cirrhosis and hepatocellular carcinoma, group II included 30 patients with liver cirrhosis without HCC, group III had 20 healthy subjects as controls. Group I was also divided into 2 subgroups, Group Ia represents patients with AFP less than 200ng/ml and Group Ib represents patients with AFP more than 200ng/ml.
In this study the age of patients in group I was higher than the other two groups with no statistically significant difference. Male: Female ratio was high in all the 3 groups with no statistically significant difference.
Regarding alpha fetoprotein its serum levels were much higher in the HCC group compared to the other two with statically significant difference.
In this study, the serum levels of Endoglin were highest in patients of group I with HCC compared to those with liver cirrhosis and the control groups with significant difference.
Serum Endoglin level was positively correlated to AFP and negatively correlated to all other patient’s parameters and laboratory data including :age, gender , smoking status , performance state , Child-Pugh score , MELD new score , BCLC staging , CBC , renal function tests and liver function tests.
Serum AFP was found to be positively correlated with number of hepatic focal lesions. However, it did not increase significantly with tumour size, vascular invasion.
Also Endoglin values was found to be positively correlated with tumor number, but not with tumor size, vascular invasion.
At a cut off value 220ng/ml, the diagnostic sensitivity and specificity of AFP for selective detection of HCC over the cirrhotic group was 67.5% and 100% respectively.
At a cut off value 1125pg/ml the diagnostic sensitivity and specificity of Endoglin for selective detection of HCC over the cirrhotic group was 90% and 76.67% respectively.
When combining both markers together the sensitivity increased to 100% with a specificity of 100%.
In conclusion, Endoglin can be used as a biomarker for hepatocellular carcinoma with a good diagnostic and prognostic value.
Other data
| Title | Evaluation of Serum Endoglin Level as a New Diagnostic Biomarker for Hepatocellular Carcinoma | Other Titles | تقييم مستوى مصل الاندوجلين كعلامة بيولوجية جديدة لتشخيص سرطان الخلايا الكبدية | Authors | Mohamed Gamal Tawfik Talkhan | Issue Date | 2017 |
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