title: Evaluation of prothrombin induced by vitamin K absence, macrophage migration inhibitory factor and Golgi protein-73 versus alpha fetoprotein for hepatocellular carcinoma diagnosis and surveillance.
abstract: Hepatocellular carcinoma (HCC) represents a challenging malignancy of worldwide importance. It is the third most common cause of cancer-related death globally as most patients present with unresectable disease. Alpha-fetoprotein (AFP) is the widely and solely used biomarker for HCC diagnosis; yet, its usefulness is hampered by low sensitivity and specificity. We aimed to identify more sensitive biomarkers for HCC diagnosis and a surveillance algorithm that may facilitate early detection of HCC. A total of 305 Egyptian and Saudi participants grouped as healthy controls, cancer controls, benign hepatic lesions, chronic viral hepatitis and HCC were included. Serum AFP, prothrombin induced by vitamin K absence-II (PIVKA-II), macrophage migration inhibitory factor (MIF) and Golgi protein-73 (GP-73) levels were quantitated by enzyme immunoassay. Significantly higher levels of GP-73 and PIVKA-II were detected in the HCC group than in all other groups, while MIF showed a highly significant increase in HCC from all groups except the cancer control group. The HCC group showed no significant difference between the studied biomarkers and the type of chronic viral hepatitis. On the basis of multiple ROC curve analyses, GP-73 and PIVKA-II showed the highest sensitivity and specificity for surveillance and diagnosis. In conclusion, PIVKA-II and GP-73 offer an effective approach for early HCC diagnosis and surveillance of high-risk groups with a higher accuracy than AFP. MIF may serve as a promising screening tumor marker for the detection of gastrointestinal tract (GIT) malignancy.
authors.affiliation: a Laboratory Medicine Department Faculty of Applied Medical Science , Umm Al Qura University , Kingdom of Saudi Arabia.|b Clinical Pathology Department , National Cancer Institute, Cairo University , Egypt.
authors.forename: Manar M
authors.initials: MM
authors.lastname: Ismail
authors.affiliation: a Laboratory Medicine Department Faculty of Applied Medical Science , Umm Al Qura University , Kingdom of Saudi Arabia.|c Medical Biochemistry Department, Faculty of Medicine , Mansoura University , Egypt.
authors.forename: Heba K
authors.initials: HK
authors.lastname: Morsi
authors.affiliation: b Clinical Pathology Department , National Cancer Institute, Cairo University , Egypt.|d Laboratory and Blood Bank Department , KAMC , Makkah , Kingdom of Saudi Arabia.
authors.forename: Nahla A B
authors.initials: NA
authors.lastname: Abdulateef
authors.affiliation: e Biostatistics and Cancer Epidemiology , National Cancer Institute, Cairo University , Egypt.
authors.forename: Maissa K
authors.initials: MK
authors.lastname: Noaman
authors.affiliation: a Laboratory Medicine Department Faculty of Applied Medical Science , Umm Al Qura University , Kingdom of Saudi Arabia.|f Department of Animal Medicine, Faculty of Veterinary Medicine , Assiut University , Egypt.
authors.forename: Ghada A
authors.initials: GA
authors.lastname: Abou El-Ella
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood*; D014408:Biomarkers, Tumor / Q000097:blood* / Q000235:genetics; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology; D016022:Case-Control Studies; D002908:Chronic Disease; D003937:Diagnosis, Differential; D005260:Female; D015870:Gene Expression; D006509:Hepatitis B / Q000097:blood / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology; D006526:Hepatitis C / Q000097:blood / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology; D006801:Humans; D019746:Intramolecular Oxidoreductases / Q000097:blood / Q000235:genetics; D008113:Liver Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology; D008263:Macrophage Migration-Inhibitory Factors / Q000097:blood / Q000235:genetics; D008297:Male; D008565:Membrane Proteins / Q000097:blood* / Q000235:genetics; D008875:Middle Aged; D011498:Protein Precursors / Q000097:blood* / Q000235:genetics; D011516:Prothrombin / Q000235:genetics; D012680:Sensitivity and Specificity; D000509:alpha-Fetoproteins / Q000235:genetics / Q000378:metabolism
chemical_list: D015415:Biomarkers; D014408:Biomarkers, Tumor; C410824:GOLM1 protein, human; D008263:Macrophage Migration-Inhibitory Factors; D008565:Membrane Proteins; D011498:Protein Precursors; D000509:alpha-Fetoproteins; C008208:acarboxyprothrombin; D011516:Prothrombin; D019746:Intramolecular Oxidoreductases; C515598:MIF protein, human
keywords: Biomarkers; ROC curve; chronic hepatitis; hepatocarcinogenesis; screening; sensitivity; specificity