Diagnostic significance of Serum Clustrin and Heat Shock Protein 70 in Hepatocellular Carcinoma Egyptian Patients
Main Article Content
Abstract
Background: The most popular primary liver cancer and the second common reason of cancer-related mortality globally is hepatocellular carcinoma (HCC). In Egypt it is considered the second cause of cancer related mortality among men. Early detection of HCC increases the success of curative treatments. Both US and AFP combined usage improves detection rates, yet expenses and false-positive rates also increase. Increased secreted Clustrin (CLU) expression is correlated with radioresistance, chemoresistance and resistance to hormones, rendering CLU a promising antitumor therapeutic goal. A highly conserved stress response protein is heat shock protein 70 (HSP70). It protects the cell and promotes a range of stimuli to induce repair.
Aim: The objective of this research was to investigate the diagnostic value of CLU and HSP70 in HCC patients in order to improve the outcome of HCC patients through early diagnosis.
Methods: A total of 120 individuals have been enrolled in this research. They were classified into 3 groups: Group 1 involved 10 healthy individuals who served as a control group. Group 2 included 20 patients diagnosed with liver cirrhosis. Group 3 HCC group was divided into two subgroups: Group (3 A): 60 patients with proved HCC before treatment. Group (3 B): 30 patients with HCC were treated using interventional radiology and followed up for 3 months post treatment. Serum levels of AFP, Clustrin and Heat shock protein 70 were assayed using ELISA technique.
Results: The comparison between healthy control group and HCC patients without any intervention revealed that serum CLU cutoff was 132.2 ng/ml with sensitivity of 96%, specificity of 97 % and accuracy of 95 %, furthermore, serum HSP 70 cut off was 38.0 ng/ml with sensitivity of 94%, specificity of 95 % and accuracy of 98 %. While AFP cut off became 114.4 ng/ml with sensitivity of 90 %, specificity of 92 % and accuracy of 91 %. These results indicate that serum CLU level and serum HSP 70 level are better diagnostic markers for HCC detection than serum AFP level.
Conclusion: CLU and HSP70 are promising and potentially complementary candidate biomarkers for effective detection of early stageHCC.