The Erythrocyte Sedimentation Rate as a Potential Hepatocellular Cancer Surveillance Tool

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Background: There is a global search for biomarkers that will aid with the diagnosis of hepatocellular carcinoma (HCC) at an early stage when it is amenable to available treatment options. The inflammatory marker – erythrocyte sedimentation rate (ESR) has been studied for several decades for its role in inflammatory processes and malignancies. We evaluate its role as a potential surveillance tool for HCC in Jos, northern Nigeria. Objective: The study aims to determine if ESR can differentiate between patients at risk of HCC who have no liver fibrosis (patients with chronic hepatitis B infection)/liver cirrhosis, and those with HCC. Methods: This is a retrospective study among adult patients aged 18 years and above using secondary data obtained from patients who were recruited for previous studies carried out at the Jos University Teaching Hospital (From August 2019 to October 2021). HCC was confirmed using a triphasic computed tomography scan. FibroScan was carried out to determine the stage of fibrosis of the liver. The ESR rate was determined using the Westergren method. ANOVA was used to determine the difference between groups of patients. Results: There were 316 participants in this study, males were 140 (44.4%) and females were 176 (55.6%). Those with HCC were 88 (27.8%) whereas, those without HCC were 228 (72.2%). The mean age of the studied population was 47 ± 11.6 years. For those with HCC, it was 48.6 ± 13.4 years and for those without HCC, it was 47.4 ± 13.3. The mean ESR for those with HCC versus those without HCC was 60.67 ± 37.9mm/h versus 22.53 ± 8.3 mm/h, P = 0.001. ESR could discriminate between those with HCC from those without HCC, with an area under the curve of .803, sensitivity of 80%, and specificity of 67%. Conclusion: There is a need for novel methods that aid the early detection of HCC since evidence has shown that surveillance and early tumor detection improve survival. ESR is a simple, easy, and cheap test that has the potential to serve as a marker of early occurrence of HCC and should be further evaluated for this property in a prospective study.