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sFRP-4, a potential novel serum marker for chronic hepatitis B-related hepatocellular carcinoma |
Cheng Xu, Xiang-Hua Zeng, Li Wang, Shi-Qi Tao, Quan-Xin Wu, Peng Zhu, Guo-Hong Deng and Yu-Ming Wang |
Chongqing, China
Author Affiliations: Institute of Infectious Diseases, Southwest Hospital, Third Military Medical University; Chongqing Key Laboratory for Research of Infectious Diseases, Chongqing 400038, China (Xu C, Zeng XH, Wang L, Tao SQ, Wu QX, Zhu P, Deng GH and Wang YM)
Corresponding Author: Yu-Ming Wang, Institute of Infectious Diseases, Southwest Hospital, Third Military Medical University, Chongqing 400038, China (Tel/Fax: +86-23-68754858; Email: wym417@163.com) |
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Abstract BACKGROUND: The current methods used for diagnosing hepatocellular carcinoma (HCC) are unsatisfactory. Here, we assessed the serum levels of secreted frizzled related protein 4 (sFRP-4) for diagnosing HCC in patients infected with chronic hepatitis B (CHB).
METHODS: In 272 patients with CHB enrolled, 142 were patients with HCC. Thirty-three healthy subjects were recruited as healthy controls. The CHB patients were assigned to a test group or a validation group based on the time of enrollment. Human antibody arrays were used to screen 15 patients (8 CHB-related HCC patients, 7 CHB patients) for serum markers. Four markers and one candidate marker were assessed in the test group and validation group, respectively.
RESULTS: Human antibody assays indicated that the serum levels of sFRP-4 in HCC patients were significantly higher than those in CHB patients (P<0.05). Additionally, serum sFRP-4 levels were significantly higher in the HCC patients than those in the non-HCC patients in both test group (79.7 vs 41.3 ng/mL; P<0.001) and validation group (89.0 vs 39.0 ng/mL; P<0.001). Areas under the Receiver Operating Characteristic curves (AUCs) for alpha-fetoprotein (AFP) and sFRP-4 were similar in both test group and validation group. In the test group, the combination of sFRP-4 (a sensitivity of 94.4%, a specificity of 60.5% at 46.4 ng/mL) and AFP (a sensitivity of 75.0%, a specificity of 87.2% at 11.3 ng/mL) showed better performance for diagnosing HCC (a sensitivity of 79.2% and a specificity of 95.3%). The AUC for combined sFRP-4 and AFP increased to 0.941 (95% CI: 0.908-0.975), and similar results were seen in the validation group.
CONCLUSION: sFRP-4 is a candidate serum marker for diagnosing HCC in CHB patients, and the combination of sFRP-4 with AFP may improve the diagnostic accuracy of HCC.
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