Assessment of the Correlation between Serum Prolidase and Alpha-Fetoprotein Levels in Egyptian Patients with Hepatocellular Carcinoma

Abstract

Background: Hepatocellular carcinoma (HCC) accounts as the sixth most common neoplasm on a global scale and the third most lethal with >600,000 deaths per year worldwide. Despite regular surveillance to detect small HCC, HCC is often diagnosed at advanced stage, after the symptoms related to HCC have appeared, and the 5-year survival rate for patients is only 7%. If HCC could be diagnosed at an early stage, potentially curative option, such as resection, ablation, and transplantation may be considered. Prolidase is an important enzyme that cleaves the bonds of dipeptides containing proline (X-pro), and plays a vital role in collagen turnover, matrix remodeling and cell growth. Metastatic tumor cell produce enhanced number of proteases that enable them to penetrate basement membrane and extracellular matrix. Therefore, tumor progression might depend on the breakdown of collagen and other extracellular matrix proteins. Aim of the work: Assess the possible diagnostic role of serum prolidase compared to alpha- fetoprotein which is the slandered marker used for diagnosis of HCC. Methods: The study was conducted upon 90 subjects who were divided into three groups: group I included 40 patients with liver cirrhosis and hepatocellular carcinoma, group II included 40 patients with HCV related liver cirrhosis without HCC, group III had 10 healthy subjects as controls. Plasma prolidase was measured by Enzyme Linked Immunosorbent assay (ELISA) using recombinant human peptidase D/prolidase (PEPD) ELISA kit lot. Results: In this study, the serum levels of serum prolidase were highest in patients of group I with HCC compared to those with liver cirrhosis and the control groups. Also, prolidase values increased with tumor number, overall size but not with vascular invasion nor with BCLC. Conclusion: There was a direct significant correlation between serum prolidase level and serum AFP level in HCC patients. Serum prolidase levels directly correlated to the tumor number and overall size so it has a good prognostic value.