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Abstract Details
Biomarkers of Oncogenesis, Adipose Tissue Dysfunction and Systemic Inflammation for the Detection of Hepatocellular Carcinoma in Patients with Nonalcoholic Fatty Liver Disease
Cancers (Basel). 2021 May 11;13(10):2305. doi: 10.3390/cancers13102305.
Gian Paolo Caviglia1, Angelo Armandi1, Chiara Rosso1, Silvia Gaia2, Serena Aneli13, Emanuela Rolle2, Maria Lorena Abate1, Antonella Olivero1, Aurora Nicolosi1, Marta Guariglia1, Davide Giuseppe Ribaldone1, Patrizia Carucci2, Giorgio Maria Saracco12, Elisabetta Bugianesi12
Author information
1Department of Medical Sciences, University of Turin, 10126 Torino, Italy.
2Gastroenterology Unit, A.O.U. Città della Salute e della Scienza, 10126 Torino, Italy.
3Department of Biology, University of Padua, 35122 Padova, Italy.
Abstract
Current surveillance strategy for patients with nonalcoholic fatty liver disease (NAFLD) at risk of hepatocellular carcinoma (HCC) development is unsatisfactory. We aimed to investigate the diagnostic accuracy of alpha-fetoprotein (AFP), protein induced by vitamin K absence or antagonist-II (PIVKA-II), glypican-3 (GPC-3), adiponectin, leptin and interleukin-6 (IL-6), alone or in combination, for the discrimination between NAFLD patients with or without HCC. The biomarkers were investigated in a cohort of 191 NAFLD patients (median age 62, 54-68 years; 121 males and 70 females) with advanced fibrosis/cirrhosis, 72 of whom had a diagnosis of HCC. PIVKA-II showed the best performance for the detection of HCC with an area under the curve (AUC) of 0.853, followed by adiponectin (AUC = 0.770), AFP (AUC = 0.763), GPC-3 (AUC = 0.759) and by IL-6 (AUC = 0.731), while the leptin values were not different between patients with and without HCC. The accuracy of the biomarkers' combination was assessed by a stratified cross-validation approach. The combination of age, gender, PIVKA-II, GPC-3 and adiponectin further improved the diagnostic accuracy (AUC = 0.948); the model correctly identified the 87% of the patients. In conclusion, we developed a model with excellent accuracy for the detection of HCC that may be useful to improve the surveillance of NAFLD patients at risk of tumor development.