Diagnostic Value of Serum Heat Shock Protein 70 in Hepatocellular Carcinoma Patients

Ahmed Elhammar,Emad Hamed,Amany Ibrahim,Amina Elnaggar

doi:10.21608/aeji.2019.14220.1029

Abstract

Background and study aim: Hepato-cellular carcinoma (HCC) is the commonest essential hepatic threat among adult. Nowadays, the HCC determination without obsessive relationship is done by imaging methods. To elucidate the role of heat shock protein 70(HSP70) in the diagnosis of HCC. Subjects and Methods: This case control study was achieved in Internal Medicine and Clinical Pathology Departments, Zagazig University, Egypt. It involved 99 participants divided into three groups; control group, cirrhotic patients and cirrhotic patients with HCC. Participants underwent complete history taking, comprehensive clinical examination, laboratory investigations including viral markers and alpha-fetoprotein. HSP 70 level was calculated via the enzyme-linked immunosorbent assay (ELISA) technique. Radiological investigations including abdominal ultrasonography and triphasic CT scan were done. Results: There was a non-significant difference between the studied groups concerning demographic characteristics. There was a significant difference between them regarding hemoglobin, platelet count, liver and kidney function tests and coagulation profile(p<0.05). Also, there was a significant difference between them as regards HSP 70, and AFP with the maximum values in HCC group. HSP 70 at cutoff ≥120 ng/ml can diagnose HCC at sensitivity 85%, specificity 50%, and accuracy 84% (p<0.05). AFP at cutoff ≥20 ng/ml can recognize HCC with sensitivity 87.5%, specificity 75.8% and accuracy 89%. Combined HSP 70 and AFP increase the sensitivity of diagnosis at 91.5% and accuracy to 93%. Conclusion: HSP 70 as a serum biomarker can be used with AFP to increase the accuracy of HCC diagnosis.

Highlights

Hepatocellular carcinoma is the fifth most common tumor among males and the seventh most malignant growth among females
There are about 30% of those patients with normal serum AFP levels are hardly diagnosed before any clinical manifestations appear, so, AFP alone is restricted and poorly reliable for early diagnosis of HCC [4]
Performance of HSP 70 and AFP in the diagnosis of HCC among the studied patients at a cutoff of HSP 70 more than or equal 120ng/ml, it can diagnose HCC with sensitivity 85%, specificity 50%, PPV 80%, NPV 75% and accuracy 84%.At a cutoff of ≥20 ng/ml, AFP can diagnose HCC at a sensitivity of 87.5%, specificity 75.8%, PPV 66.7%, NPV 89% and accuracy 89%

Summary

Introduction

Hepatocellular carcinoma is the fifth most common tumor among males and the seventh most malignant growth among females. In 2001, non-invasive imaging technique was accepted to diagnose HCC in presence of a cirrhotic liver [2]. As early small lesions are asymptomatic and there is shortage of satisfactory diagnostic and screening strategies, most patients (>80%) present with an advanced phase. Serum alpha-fetoprotein (AFP) level and ultrasonography are the most utilized screening procedures in cirrhotic patients [3]. There are about 30% of those patients with normal serum AFP levels are hardly diagnosed before any clinical manifestations appear, so, AFP alone is restricted and poorly reliable for early diagnosis of HCC [4]. Hepatocellular carcinoma (HCC) is the commonest essential hepatic threat among adult. The HCC determination without obsessive relationship is done by imaging methods. To elucidate the role of heat shock protein 70(HSP70) in the diagnosis of HCC

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Conclusion