Ali Lamia H, Higazi Aliaa M, Moness Hend M, Farag Naglaa M, Saad Zienab M, Moukareb Hamdy A, Soliman Wael, El Sagheer Ghada, Abd El Hamid Sahar R, Abdl Hamid Haytham
Department of Clinical and Chemical Pathology, Faculty of Medicine, Minia University, Minia, Egypt,
Department of Tropical Medicine, Faculty of Medicine, Minia University, Minia, Egypt.
Clin Exp Gastroenterol. 2019 Feb 1;12:51-66. doi: 10.2147/CEG.S179832. eCollection 2019.
Hepatocellular carcinoma (HCC) is one of the most common cancers worldwide. It has been widely established that the early detection of HCC enables more treatment options with improvements in prognosis and survival.
The aim of this study was to assess the diagnostic accuracy of both circulating miR-215 and squamous cell carcinoma antigen-IgM (SCCA-IgM) as serum biomarkers for HCC by examining their diagnostic sensitivity, specificity, accuracy, and predictive values in hepatitis C virus (HCV)-induced HCC patients.
This study included 60 patients with HCV-related HCC. In addition, 60 patients with HCV-related liver cirrhosis (LC) and 60 apparently healthy subjects were involved, and served as diseased and healthy control groups, respectively. The relative expression levels of miR-215 were detected using quantitative real-time PCR. SCCA-IgM levels in serum were measured by enzyme immunoassay. We used receiver operating characteristic (ROC) curve to calculate the diagnostic accuracy against alpha-fetoprotein (AFP).
Relative miR-215 expression levels increased the most in HCC patients compared to that in healthy or diseased controls (<0.001). Serum concentration of SCCA-IgM was significantly higher in HCC group than that in the two control groups. We performed multivariate analysis using AFP level, focal lesion size, and portal vein thrombosis as independent variables. ROC curves showed that the optimum diagnostic miR-215 cutoff value for identifying HCC patients from cirrhotic ones was 417 (sensitivity, 97%; specificity, 91%) and for SCCA-IgM was 95 AU/mL (sensitivity, 92%; specificity, 98%). Moreover, the superiority of both miR-215 and SCCA-IgM to AFP is obvious in our study and this superiority is more evident in distinguishing HCC with AFP levels <200 ng/mL and HCC patients with small-sized focal lesions from cirrhotic patients.
Cell-free miR-215 and serum SCCA-IgM could be used for early diagnosis of HCC either each one as a single marker or with AFP complement measurement.
肝细胞癌（HCC）是全球最常见的癌症之一。广泛认为，HCC的早期检测可带来更多治疗选择，改善预后和生存率。
本研究旨在通过检测循环miR-215和鳞状细胞癌抗原IgM（SCCA-IgM）在丙型肝炎病毒（HCV）诱导的HCC患者中的诊断敏感性、特异性、准确性和预测价值，评估其作为HCC血清生物标志物的诊断准确性。
本研究纳入60例HCV相关HCC患者。此外，纳入60例HCV相关肝硬化（LC）患者和60例健康对照者，分别作为疾病组和健康对照组。采用定量实时PCR检测miR-215的相对表达水平。采用酶免疫法检测血清SCCA-IgM水平。我们使用受试者操作特征（ROC）曲线计算相对于甲胎蛋白（AFP）的诊断准确性。
与健康或疾病对照组相比，HCC患者中miR-215的相对表达水平升高最为明显（<0.001）。HCC组血清SCCA-IgM浓度显著高于两个对照组。我们以AFP水平、局灶性病变大小和门静脉血栓形成作为自变量进行多因素分析。ROC曲线显示，从肝硬化患者中鉴别HCC患者的最佳诊断miR-215临界值为417（敏感性97%；特异性91%），SCCA-IgM的最佳诊断临界值为95 AU/mL（敏感性92%；特异性98%）。此外，在我们的研究中，miR-215和SCCA-IgM相对于AFP的优越性明显，且在区分AFP水平<200 ng/mL的HCC患者以及小尺寸局灶性病变的HCC患者与肝硬化患者方面，这种优越性更为明显。
游离miR-215和血清SCCA-IgM均可单独作为单一标志物，或与AFP补充检测一起用于HCC的早期诊断。
