Evaluation of plasma osteopontin level as a biomarker for hepatocellular carcinoma in Egyptian patients

ABSTRACT

Hepatocellular carcinoma [HCC] is a major health problem worldwide. Up to 80% of HCCs develop against a background of cirrhosis of the liver, and although we believe that surveillance of the at-risk cirrhotic population could aid earlier detection of the disease and decrease the cancer-related mortality rate, our this success is limited by the lack of sensitive biomarkers. To evaluate plasma osteopontin level as a potential marker of HCC compared with alpha fetoprotein. This study was conducted on 80 patients classified into two groups [HCC group n=40] and chronic liver disease group n=40], in addition to 30 age-matched and sexmatched healthy participants as a control group. HCC was diagnosed histologically or by imaging. Plasma alpha fetoprotein and plasma osteopontin levels were quantitatively determined using enzyme-linked immunosorbent assay kits. Plasma osteopontin level was significantly higher in patients with HCC compared with chronic liver disease and control participants [P<0.01]. Osteopontin at the best cutoff value [325.5 micro g/ml] had sensitivity of 87.5%, specificity of 80%, positive predictive value of 85.3%, and negative predictive value of 82.7% for detection of HCC cases [area under the curve=0.876]. Osteopontin level was not correlated to a fetoprotein level. Comparing osteopontin with a fetoprotein for prediction of patients with HCC, alpha fetoprotein at a cut-off value of 200 micro g/ml failed to predict 21 patients [52.5%], of whom 16 patients [76%] would be diagnosed by elevated osteopontin above 325 micro g/ml [cut-off value]. OPN is clearly a potential diagnostic marker for HCC. Osteopontin level of 325 micro g/ml was proposed as a significant cut-off value for the diagnosis of HCC