Gastroenterology & Hepatology Unit ,Department of Internal Medicine , Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Egypt J Immunol. 2022 Apr;29(2):26-40.
Hepatocellular carcinoma (HCC) is one of the most common aggressive tumors, with a rising prevalence in Egypt. Clusterin is a secretory heterodimeric glycoprotein linked to cancer development and progression. This study was conducted to evaluate the diagnostic and prognostic role of serum clusterin as a possible biomarker of HCC and correlate its level with the mRECIST scoring system. This study included 45 patients with liver cirrhosis and HCC eligible for locoregional treatment and 20 patients with liver cirrhosis without HCC as controls. All patients underwent standard laboratory tests and abdominal ultrasound. For HCC patients, a triphasic CT scan, alpha-fetoprotein (AFP), and clusterin levels were measured at baseline and one month after intervention. HCC patients had a substantially higher baseline clusterin level than cirrhotic patients (122.291 ± 61.898 vs. 74.015 ± 41.571, P = 0.002). Five patients in the HCC group were not eligible for intervention because they had evidence of portal vein invasion. At one month follow-up after HCC treatment, serum clusterin levels declined significantly from baseline (from 122.291 ± 61.898 to 81.125 ± 62.321, P = < 0.001). According to the mRECIST scoring, baseline clusterin levels were significantly higher among patients with progressive disease than those with partial response than those with complete response (180.722 ± 55.908, 161.310 ± 56.339, 84.810± 41.389, respectively, overall P = < 0.001). Clusterin was a useful marker in detecting HCC with 73.33% sensitivity and 75% specificity at a cutoff of ≥ 86.6 mg/L, and it also had 95.24% sensitivity and 77.78% specificity in detecting tumor progression at a cutoff of ≥ 146.6 mg/L, according to the mRECIST scoring system. In conclusion, clusterin may be a helpful diagnostic and prognostic marker for HCC after locoregional treatment, as its baseline level is useful in predicting response and progression of HCC in correlation with the mRECIST scoring system.
肝细胞癌（HCC）是最常见的侵袭性肿瘤之一，在埃及呈上升趋势。聚集蛋白是一种与癌症发展和进展相关的分泌性异二聚体糖蛋白。本研究旨在评估血清聚集蛋白作为 HCC 潜在生物标志物的诊断和预后作用，并将其水平与 mRECIST 评分系统相关联。本研究纳入了 45 名符合局部区域治疗条件的肝硬化合并 HCC 患者和 20 名肝硬化无 HCC 患者作为对照。所有患者均接受了标准实验室检查和腹部超声检查。对于 HCC 患者，在基线和干预后 1 个月时测量了三期 CT 扫描、甲胎蛋白（AFP）和聚集蛋白水平。与肝硬化患者相比，HCC 患者的基线聚集蛋白水平明显更高（122.291±61.898 vs. 74.015±41.571，P=0.002）。HCC 组中有 5 名患者因门静脉侵犯证据不符合干预条件。在 HCC 治疗后 1 个月的随访中，血清聚集蛋白水平从基线显著下降（从 122.291±61.898降至 81.125±62.321，P＜0.001）。根据 mRECIST 评分，进展性疾病患者的基线聚集蛋白水平明显高于部分反应患者，高于完全反应患者（180.722±55.908、161.310±56.339、84.810±41.389，总体 P＜0.001）。在 mRECIST 评分系统中，聚集蛋白在检测 HCC 方面具有 73.33%的灵敏度和 75%的特异性，当截断值≥86.6mg/L 时，其检测肿瘤进展的灵敏度和特异性分别为 95.24%和 77.78%。综上所述，聚集蛋白可能是局部区域治疗后 HCC 的一种有用的诊断和预后标志物，其基线水平可用于预测 HCC 的反应和进展，与 mRECIST 评分系统相关联。
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