Diagnostic role of serum glypican-3 in differentiating hepatocellular carcinoma from non-malignant chronic liver disease and other liver cancers.
OBJECTIVE
The role of glypican-3 (GPC3), a novel serum marker, in differentiating hepatocellular carcinoma (HCC) from non-malignant chronic liver disease and other malignant space-occupying lesions in the liver is largely unknown. The aims of this study were to evaluate its diagnostic role and clinical correlations in patients with HCC.


METHODS
Six groups were studied which included 40 healthy subjects, 50 patients with chronic hepatitis (CH), 50 patients with liver cirrhosis (LC), 100 patients with HCC, 50 patients with intrahepatic cholangiocarcinoma (ICC) and 50 patients with metastatic carcinoma (MCA). Serum GPC3 levels were measured by using a sandwich enzyme-linked immunosorbent assay method.


RESULTS
Fifty-three percent of HCC patients had elevated serum GPC3 levels with values ranging 35.5-7826.6 ng/mL. The serum marker was undetectable in other groups except one patient (2%) with LC and another patient (2%) with MCA. In most cases of HCC, elevated GPC3 values did not correlate with alpha-fetoprotein (AFP) levels. Detectable GPC3 was significantly correlated with the presence of viral hepatitis markers but was not correlated with tumor size and stage of HCC. Serum GPC3 was superior to AFP in detecting small HCC (56.3% and 31.3%, respectively). A combination of serum GPC3 and AFP yielded an improved sensitivity for detecting small HCC to 75%.


CONCLUSIONS
Serum GPC3 is highly specific for detecting HCC. The combined use of serum GPC3 and AFP provides a potentially promising tool to better differentiate HCC from benign liver disorders, as well as from other liver cancers.
Department of Biochemistry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. pisittkvn@yahoo.com
Pisit
P
Tangkijvanich
Theerawut
T
Chanmee
Sanpoj
S
Komtong
Varocha
V
Mahachai
Naruemon
N
Wisedopas
Peraphan
P
Pothacharoen
Prachya
P
Kongtawelert
D000328:Adult; D000368:Aged; D001650:Bile Duct Neoplasms / Q000097:blood / Q000175:diagnosis; D001653:Bile Ducts, Intrahepatic / Q000473:pathology; D014408:Biomarkers, Tumor / Q000097:blood*; D006528:Carcinoma, Hepatocellular / Q000097:blood* / Q000175:diagnosis / Q000473:pathology; D018281:Cholangiocarcinoma / Q000097:blood / Q000175:diagnosis; D003937:Diagnosis, Differential; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D053673:Glypicans / Q000097:blood*; D006521:Hepatitis, Chronic / Q000097:blood / Q000175:diagnosis; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood / Q000175:diagnosis; D008113:Liver Neoplasms / Q000097:blood* / Q000175:diagnosis / Q000556:secondary; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D012372:ROC Curve; D012680:Sensitivity and Specificity; D015854:Up-Regulation; D000509:alpha-Fetoproteins / Q000032:analysis
C097353:AFP protein, human; D014408:Biomarkers, Tumor; C105937:GPC3 protein, human; D053673:Glypicans; D000509:alpha-Fetoproteins