title: Serum autoantibody measurement for the detection of hepatocellular carcinoma.
abstract: BACKGROUND
  Individuals with liver disease, and especially those with Hepatitis B or C, are at an increased risk of developing hepatocellular carcinoma (HCC) which is the third most common cause of cancer-related death worldwide. Inadequate screening tests largely account for presentation of advanced tumours and high mortality rates. Early detection of HCC amongst high-risk groups is paramount in improving prognosis. This research aimed to further characterise the previously described humoral immune response raised to tumour-associated antigens (TAAs) in the serum of patients with HCC.
  
  
  METHODS
  Serum from 96 patients with confirmed HCC, 96 healthy controls matched for age and sex, 78 patients with confirmed liver cirrhosis and 91 patients with confirmed chronic liver disease were analysed for the presence of IgG autoantibodies raised to 41 recombinant TAAs/antigen fragments by ELISA.
  
  
  RESULTS
  Varying autoantibody specificities (97-100%) and sensitivities (0-10%) were observed to individual TAAs. A 21-antigen panel achieved a specificity of 92% and sensitivity of 45% for the detection of HCC. This same panel identified 21% of 169 high-risk controls as having elevated autoantibody levels. A reproducible panel of 10 antigens achieved a specificity of 91% and sensitivity of 41% in HCC. 15% of 152 high-risk controls gave positive results with this panel.
  
  
  CONCLUSIONS
  This minimally invasive blood test has the potential to offer advantages over currently available tools for the identification of HCC amongst pre-disposed patients. Results are comparable to current gold standards in HCC (Ultrasonography) and to similar tests in other cancers (EarlyCDT-Lung).
authors.affiliation: Centre of Excellence for Autoimmunity in Cancer, School of Medicine, University of Nottingham, Nottingham, United Kingdom.
authors.forename: Catrin H
authors.initials: CH
authors.lastname: Middleton
authors.affiliation: Nottingham Digestive Diseases Biomedical Research Unit, Queen's Medical Centre, Nottingham, United Kingdom.
authors.forename: William
authors.initials: W
authors.lastname: Irving
authors.affiliation: Centre of Excellence for Autoimmunity in Cancer, School of Medicine, University of Nottingham, Nottingham, United Kingdom.
authors.forename: John F R
authors.initials: JF
authors.lastname: Robertson
authors.affiliation: Oncimmune Ltd, Nottingham, United Kingdom.
authors.forename: Andrea
authors.initials: A
authors.lastname: Murray
authors.affiliation: Oncimmune Ltd, Nottingham, United Kingdom.
authors.forename: Celine B
authors.initials: CB
authors.lastname: Parsy-Kowalska
authors.affiliation: Oncimmune Ltd, Nottingham, United Kingdom.
authors.forename: Isabel K
authors.initials: IK
authors.lastname: Macdonald
authors.affiliation: Oncimmune Ltd, Nottingham, United Kingdom.
authors.forename: Jane
authors.initials: J
authors.lastname: McElveen
authors.affiliation: Oncimmune Ltd, Nottingham, United Kingdom.
authors.forename: Jared
authors.initials: J
authors.lastname: Allen
authors.affiliation: Oncimmune Ltd, Nottingham, United Kingdom.
authors.forename: Graham F
authors.initials: GF
authors.lastname: Healey
authors.affiliation: Nottingham Digestive Diseases Biomedical Research Unit, Queen's Medical Centre, Nottingham, United Kingdom.
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Thomson
authors.affiliation: Nottingham Digestive Diseases Biomedical Research Unit, Queen's Medical Centre, Nottingham, United Kingdom.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Ryder
authors.affiliation: Institute of Clinical Chemistry and Clinical Pharmacology, University Hospital Bonn, Bonn, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Holdenrieder
authors.affiliation: Centre of Excellence for Autoimmunity in Cancer, School of Medicine, University of Nottingham, Nottingham, United Kingdom.
authors.forename: Caroline J
authors.initials: CJ
authors.lastname: Chapman
mesh_terms: D000328:Adult; D000368:Aged; D001323:Autoantibodies / Q000097:blood*; D014408:Biomarkers, Tumor / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000175:diagnosis* / Q000276:immunology; D016022:Case-Control Studies; D055088:Early Detection of Cancer / Q000379:methods*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000097:blood / Q000150:complications / Q000276:immunology; D008113:Liver Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000276:immunology; D008297:Male; D008875:Middle Aged
chemical_list: D001323:Autoantibodies; D014408:Biomarkers, Tumor
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