title: Identification of osteopontin as a novel marker for early hepatocellular carcinoma.
abstract: The aim of this study was to identify a biomarker that could improve alpha-fetoprotein (AFP) performance in hepatocellular carcinoma (HCC) surveillance among patients with cirrhosis. We performed proteomic profiling of plasma from patients with cirrhosis or HCC and validated selected candidate HCC biomarkers in two geographically distinct cohorts to include HCC of different etiologies. Mass spectrometry profiling of highly fractionated plasma from 18 cirrhosis and 17 HCC patients identified osteopontin (OPN) as significantly up-regulated in HCC cases, compared to cirrhosis controls. OPN levels were subsequently measured in 312 plasma samples collected from 131 HCC patients, 76 cirrhosis patients, 52 chronic hepatitis C (CHC) and B (CHB) patients, and 53 healthy controls in two independent cohorts. OPN plasma levels were significantly elevated in HCC patients, compared to cirrhosis, CHC, CHB, or healthy controls, in both cohorts. OPN alone or in combination with AFP had significantly better area under the receiver operating characteristic curve, compared to AFP, in comparing cirrhosis and HCC in both cohorts. OPN overall performance remained higher than AFP in comparing cirrhosis and the following HCC groups: HCV-related HCC, HBV-associated HCC, and early HCC. OPN also had a good sensitivity in AFP-negative HCC. In a pilot prospective study including 22 patients who developed HCC during follow-up, OPN was already elevated 1 year before diagnosis.
  
  
  CONCLUSIONS
  OPN was more sensitive than AFP for the diagnosis of HCC in all studied HCC groups. In addition, OPN performance remained intact in samples collected 1 year before diagnosis.
authors.affiliation: Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA.
authors.forename: Sufen
authors.initials: S
authors.lastname: Shang
authors.forename: Amelie
authors.initials: A
authors.lastname: Plymoth
authors.forename: Shaokui
authors.initials: S
authors.lastname: Ge
authors.forename: Ziding
authors.initials: Z
authors.lastname: Feng
authors.forename: Hugo R
authors.initials: HR
authors.lastname: Rosen
authors.forename: Suleeporn
authors.initials: S
authors.lastname: Sangrajrang
authors.forename: Pierre
authors.initials: P
authors.lastname: Hainaut
authors.forename: Jorge A
authors.initials: JA
authors.lastname: Marrero
authors.forename: Laura
authors.initials: L
authors.lastname: Beretta
mesh_terms: D014408:Biomarkers, Tumor / Q000097:blood*; D006528:Carcinoma, Hepatocellular / Q000097:blood* / Q000175:diagnosis; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood* / Q000175:diagnosis; D008297:Male; D013058:Mass Spectrometry; D053495:Osteopontin / Q000097:blood*; D040901:Proteomics
chemical_list: D014408:Biomarkers, Tumor; D053495:Osteopontin