Survey of the serum hepatocellular carcinoma marker Golgi glycoprotein (GP73) among Qidong residents and correlation analysis to outcome at two-year follow-up

Abstract

To survey the levels of Golgi glycoprotein (GP73), a hepatocellular carcinoma (HCC) marker, in residents of Qidong and determine the correlation of detected GP73 concentration ranges with outcome at two-year follow-up. A total of 12,378 individuals (age range: 35-69 years old) from Qidong were enrolled in the study. All participants were tested for hepatitis B virus (HBV) by detecting hepatitis B surface antigen (HBsAg) in serum. One-tenth of the participants were assigned to a stratified-random sample group (those with identification numbers ending with "0") to represent a "subgroup of the natural population" (HBsAgPop, n = 1227). All HBsAg carriers were stratified as a "subgroup of positivity" (HBsAgPve, n = 1025). One-tenth of all HBsAg-negative individuals were assigned to a stratified-random sample group to represent a "subgroup of negativity" (HBsAgNve, n = 1132). Enzyme-linked immunoassay was used to measure the serum GP73 and alpha-fetoprotein (AFP) levels; the distribution, medians (50th percentile), and 95th percentiles of GP73 were determined for the three subgroups. A two-year follow-up was carried out to observe the differential incidence of HCC between the HBsAgPve and HBsAgNve subgroups. A positively skewed distribution of the GP73 values was observed for all three subgroups. The medians for HBsAgPve, HBsAgNve, and HBsAgPop were 67 mug/L, 54 mug/L, and 55 mug/L; the 95th percentiles were 174 mug/L, 108 mug/L, and 114 mug/L, respectively. The AFP positivity rates were 7.23% (37/512) for carriers whose GP73 values were above the median level and 0.78% (4/513) for carriers with GP73 values below the median level, with a highly significant difference between the two (P less than 0.01). A the two-year follow-up, 23 (4.49%) of the 512 carriers with GP73 more than or equal to 67 mug/L had developed HCC, while only one patient (0.19%) of the 513 carriers with GP73 less than 67 mug/L developed HCC, which yielded a relative risk value of 23.6. In the non-carriers, no HCC cases had occurred, regardless of serum GP73 level. Serum GP73 has a higher potential as a diagnostic/prognostic marker of HCC in individuals with HBsAg positivity. In follow-up of HBsAg carriers, GP73 may help in the early detection of liver cancer.