Diagnostic and prognostic significance of secretory clusterin expression in patients with hepatocellular carcinoma.
The upregulation of secretory clusterin (sCLU) is associated with tumor progression by contributing to angiogenesis, chemo-resistance, cell survival, and metastasis. However, its diagnostic or prognostic values for hepatocellular carcinoma (HCC) still remain to be clarified. The average serum sCLU level analyzed by an enzyme-linked immunosorbent assay was significantly higher (P < 0.001) in HCC patients than that in any of cases with cirrhosis, chronic hepatitis, or healthy control. The area under receiver operating characteristic curve and diagnostic sensitivity were 0.75 and 74.7 % in sCLU, and 0.74 and 58.7 % in α-fetoprotein (AFP), respectively. The combining detections of sCLU and AFP rose up to 90.7 % for HCC diagnosis. In liver, sCLU by immunohistochemistry was significantly higher (P < 0.001) in the HCC (77.3 %) group than that in their para-cancerous group (33.3 %). Abnormal serum or tissue sCLU expression was closely associated with tumor-node-metastasis (TNM) classification of malignant tumors and lymph node metastasis, as an independent prognosis factor (hazard ratio, 2.287; 95 % confidence interval, 1.044-5.007; P = 0.039), and higher sCLU expression significantly correlated (χ (2) = 4.252, P = 0.039) with poor survival of HCC patients analyzed by multivariate Cox regression or Kaplan-Meier method, suggesting that abnormal sCLU expression associated with tumor progression could be a potential diagnostic and prognostic biomarker for HCC.
Research Center of Clinical Medicine, Affiliated Hospital of Nantong University, 20 West Temple Road, Nantong, 226001, Jiangsu, China.
Wenjie
W
Zheng
Department of Immunology, Medical School of Nantong University, Nantong, 226001, Jiangsu, China.
Min
M
Yao
Research Center of Clinical Medicine, Affiliated Hospital of Nantong University, 20 West Temple Road, Nantong, 226001, Jiangsu, China.
Wenli
W
Sai
Department of Oncology, Affiliated Hospital of Nantong University, Nantong, 226001, Jiangsu, China.
Qi
Q
Qian
Department of Oncology, Affiliated Hospital of Nantong University, Nantong, 226001, Jiangsu, China.
Liuhong
L
Pan
Research Center of Clinical Medicine, Affiliated Hospital of Nantong University, 20 West Temple Road, Nantong, 226001, Jiangsu, China.
Liwei
L
Qiu
Department of Pathology, Affiliated Hospital of Nantong University, Nantong, 226001, Jiangsu, China.
Jianfei
J
Huang
Research Center of Clinical Medicine, Affiliated Hospital of Nantong University, 20 West Temple Road, Nantong, 226001, Jiangsu, China.
Wei
W
Wu
Research Center of Clinical Medicine, Affiliated Hospital of Nantong University, 20 West Temple Road, Nantong, 226001, Jiangsu, China. yaodf@ahnmc.com.
Dengfu
D
Yao
D000328:Adult; D000368:Aged; D015415:Biomarkers; D014408:Biomarkers, Tumor; D006528:Carcinoma, Hepatocellular / Q000097:blood* / Q000175:diagnosis* / Q000401:mortality; D051152:Clusterin / Q000097:blood*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008107:Liver Diseases / Q000097:blood; D008113:Liver Neoplasms / Q000097:blood* / Q000175:diagnosis* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D012372:ROC Curve; D015203:Reproducibility of Results; D047368:Tumor Burden
D015415:Biomarkers; D014408:Biomarkers, Tumor; D051152:Clusterin
Clusterin; Diagnosis; Hepatocellular carcinoma; Prognosis