title: Human liver carboxylesterase 1 outperforms alpha-fetoprotein as biomarker to discriminate hepatocellular carcinoma from other liver diseases in Korean patients.
abstract: Although alpha-fetoprotein (AFP) is currently the major serologic biomarker for hepatocellular carcinoma (HCC), it cannot efficiently distinguish this cancer from other forms of liver disease in early diagnosis due to its low sensitivity. The aim of this study is to compare sensitivity and specificity of human carboxylesterase 1 (hCE1) and AFP biomarker. Antibody-based assays for hCE1 and AFP were used to test both biomarkers with respect to diagnostic efficiency, Youden's index and the area under the curve (AUC) through receiver operating characteristic (ROC) analysis in plasma from 208 patients with HCC (n=57), liver cirrhosis (n=27), chronic hepatitis (n=37), cholangiocarcinoma (n=22), gastric cancer (n=31) and pancreatic cancer (n=34), along with 52 healthy donors (HDs). The levels of hCE1 were significantly higher in patients with HCC than HDs and the other diseases (p<0.005), further verified by AUC values and Youden's index. In the set of HCC versus liver cirrhosis the AUC values were 0.744 (AFP), 0.918 (hCE1) and 0.938 (combination of AFP and hCE1), respectively. These results indicate that hCE1 is not only a more potent and specific marker in distinguishing cancer from liver diseases, in particular cirrhosis, but the combination of hCE1 and AFP shows also synergistic potential for greater sensitivity and specificity in early diagnosis. Therefore the antibody-based hCE1 assay appears to have high diagnostic efficiency for discriminating HCC from other forms of liver disease. It is now feasible to further validate this novel plasma-based biomarker in the large cohort we assembled.
authors: Yonsei Proteome Reasearch Center, Yonsei University, Seoul, Korea.
authors: Keun
authors: K
authors: Na
authors: Seul-Ki
authors: SK
authors: Jeong
authors: Min Jung
authors: MJ
authors: Lee
authors: Sang Yun
authors: SY
authors: Cho
authors: Sun A
authors: SA
authors: Kim
authors: Min-Ji
authors: MJ
authors: Lee
authors: Si Young
authors: SY
authors: Song
authors: Hoguen
authors: H
authors: Kim
authors: Kyung Sik
authors: KS
authors: Kim
authors: Hyun Woong
authors: HW
authors: Lee
authors: Young-Ki
authors: YK
authors: Paik
mesh_terms: D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal; D019540:Area Under Curve; D014408:Biomarkers, Tumor / Q000378:metabolism*; D002265:Carboxylic Ester Hydrolases / Q000235:genetics / Q000378:metabolism*; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000175:diagnosis*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000097:blood / Q000175:diagnosis*; D008113:Liver Neoplasms / Q000097:blood / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D040901:Proteomics; D012372:ROC Curve; D012680:Sensitivity and Specificity; D000509:alpha-Fetoproteins / Q000378:metabolism*
chemical_list: D000911:Antibodies, Monoclonal; D014408:Biomarkers, Tumor; D000509:alpha-Fetoproteins; D002265:Carboxylic Ester Hydrolases; C474609:CES1 protein, human