Genes Expression and Serum Biomarkers for Diagnosis of Hepatocellular Carcinoma, Cirrhosis and Hepatitis C

Abstract

Background: Hepatocellular carcinoma (HCC) is the most common type of liver cancer. Risk factors for HCC include hepatitis C (HCV) and B (HBV) virus infection, alcoholic cirrhosis and genetic alterations that can affect several cellular pathways. Objective: This study purposed to analyze the gene and serum protein expression of vascular endothelial growth factor (VEGF), angiogenesis, alpha fetoprotein, cystatin B (CSTB), β-catenin and glypican-3 (GPC3) in groups with HCC, cirrhosis or HCV and controls, and their relation with clinical staging in the HCC and cirrhosis groups, as well its sensitivity and specificity values. Methods: A total of 230 individuals were distributed in Group 1 (G1) - 80 patients with HCC; Group 2 (G2) - 76 patients with cirrhosis due to any etiology; Group 3 (G3) - 33 patients with HCV; Group 4 (G4 - controls) - 41 individuals without clinical or biochemical signs of any liver disease. Gene expression was analyzed by qRT-PCR and serum proteins were performed using the ELISA method. Results: Increased VEGF and angiogenesis, alpha fetoprotein expression could be observed in BCLC stage-D patients compared to stage-B patients, and stage-C patients showed higher expression of β-catenin, compared to stage-B patients (P<0.05). For VEGF and GPC3, discriminatory power was observed between HCC patients and controls (AUC =0.71; 0.82, respectively). CSTB showed discriminatory power in the comparison between patients with HCV and controls (AUC =0.74). Conclusion The present study confirms the sensitivity of serum CSTB in the diagnosis of hepatitis C, and gene expression of VEGF and serum GPC3, confer both sensitivity and specificity for the diagnosis of HCC.

The Evolving Field of Hepatology in Brazil

“…The authors suggested that HOMA IR could be a valuable tool to identify those patients with non-alcoholic steatohepatitis, but prospective validation and comparison of HOMA IR with other readily available non-invasive markers of fibrosis in the Brazilian population is still an unmet need. Fernandes Ferreira et al (15) , on the other hand, have investigated serum and gene expression of several markers of angiogenesis and cell differentiation in subjects with HCC. The authors have correlated overexpression of vascular endothelial growth factor and alpha fetoprotein in liver tissue of subjects with HCC, particularly in those with advanced stages according to BCLC classification.…”