Urine Neutrophil Gelatinase-Associated Lipocalin a Possible Diagnostic Marker for Egyptian Hepatocellular Carcinoma Patients

Abstract

Background: Most effective method for reducing mortality from hepatocellular carcinoma (HCC) is early diagnosis. Despite its lack of adequate sensitivity, ultrasound is considered fundamental for HCC screening. Aim: to evaluate urinary neutrophil gelatinase-associated lipocalin (NGAL) as non-invasive marker for HCC diagnosis in Egyptian patients. Methods: One hundred and twenty patients were divided into three groups (40 patients each): patients with chronic viral hepatitis (HCV or HBV), cirrhotic patients and HCC patients and 40 healthy age and gender matched subjects were enrolled as control group. After clinical assessments, urinary NGAL was measured by enzyme-linked immunosorbent assay. Results: Our results revealed that median level of urinary NGAL was 290, 834, 1090 and 1925 pg/ml in control, chronic hepatitis, cirrhotic and HCC groups respectively among studied groups (p<0.001). Receiver operating characteristics (ROC) analysis showed that urinary NGAL cutoff value of 1255 ng/ml could discriminate between HCC and cirrhosis. The area under curve (AUC) was 0.95 with 90% sensitivity, 87.5% specificity (p-value <0.001). In HCC group, urine NGAL level didn`t show significant correlation with Child Pugh score, MELD score or Barcelona Clinic Liver Cancer (BCLC) stage. Conclusion: Urinary NGAL could be a simple, non-invasive test for diagnosis of HCC in chronic liver disease patients.

Bioinformatic analysis of the LCN2–SLC22A17–MMP9 network in cancer: The role of DNA methylation in the modulation of tumor microenvironment

“…Interestingly, the expression of both LNC2 and MMP9 genes was increased in 16 tumor types, demonstrating their involvement in tumor development. This result was consistent with those reported in the literature for several tumors, including BLCA ( Ricci et al, 2015 ; Candido et al, 2016b ), CESC ( Li et al, 2012 ), CHOL ( Leelawat et al, 2011 ; Nair et al, 2018 ; Li et al, 2019 ), ESCA ( Zhang et al, 2007 ), HNSC ( Ruokolainen et al, 2005 ; Hiromoto et al, 2011 ; Stanciu et al, 2016 ; Verma et al, 2017 ), KIRP ( Cho et al, 2003 ; Zhang et al, 2015 ), LIHC ( Chen et al, 2012 ; Abdelsameea et al, 2020 ), LUAD ( Ruiz-Morales et al, 2015 ), OV ( Cho and Kim, 2009 ; Gupta et al, 2022 ); PAAD ( Kaur et al, 2013 ), STAD ( Du et al, 2011 ), UCEC ( Cymbaluk-Płoska et al, 2017 ), COAD ( Yang et al, 2014 ; Ozemir et al, 2016 ; Liang and Chang, 2018 ), LUSC ( Lee et al, 2015 ), PRAD ( Ma et al, 2017 ; Muşlu et al, 2017 ; Ulusoy et al, 2021 ), READ ( Zhang et al, 2009 ; Annaházi et al, 2016 ), and THCA ( Barresi et al, 2012 ; Liu et al, 2019 ; Xu et al, 2019 ).…”

A Scoping Review on Lipocalin-2 and Its Role in Non-Alcoholic Steatohepatitis and Hepatocellular Carcinoma

“…Moreover, they found that LCN2 levels are able to discriminate between HCC and liver cirrhosis subjects, and they also proved that LCN2 levels are not suitable to distinguish between early and late HCC. This goes along with an Egyptian study showing how even urine LCN2 can serve as a marker in HCC diagnosis [91]. In the respective study, LCN2 levels were significantly elevated in patients with HCC in contrast to the control, cirrhotic patients, and patients with chronic hepatitis.…”

Urinary NGAL in gastrointestinal diseases can be used as an indicator of early infection in addition to acute kidney injury marker

“…Although we did not search for hepatocellular carcinoma cases in this study, this is a very interesting report that also explores the mechanism behind the elevated levels. 20 Oikonomou et al . reported that NGAL is elevated in active IBD and correlates with established inflammatory markers and disease activity.…”