The role of UCA1 and WRAP53 in diagnosis of hepatocellular carcinoma: A single-center case-control study.

Aim of the study: Hepatocellular carcinoma (HCC) prognosis heavily depends on early diagnosis. We aimed to determine the role of serum urothelial carcinoma-associated 1 (UCA1) and wd repeat containing antisense to TP53 (WRAP53) as diagnostic tools of HCC. Material and methods: A case-control study including 90 subjects (30 patients having HCC, 30 patients having liver cirrhosis without HCC and 30 healthy controls) was performed. In all participants, the serum levels of UCA1 and WRAP53 were assessed by quantitative real-time polymerase chain reaction together with serumαa-fetoprotein (AFP). Results: Serum levels of both UCA1 and WRAP53 were upregulated in patients with HCC being significantly higher than in patients with liver cirrhosis and healthy control (p < 0.001). They were also correlated with some clinicopathological characteristics of HCC. Using the receiver operating curve, both UCA1 and WRAP53 showed higher diagnostic performance for HCC (AUC = 0.9, 73.3% sensitivity, 100% specificity and AUC = 0.85, 63.3% sensitivity, 80% specificity respectively) and their combination with AFP resulted in improved sensitivity and specificity (AUC = 0.97, 90% sensitivity, 100% specificity). Conclusions: Serum UCA1 and WRAP53 have the potential to be used alone, or in combination or with AFP, as diagnostic non-invasive biomarkers for HCC with accepted sensitivity and specificity. This study has been registered in clinicaltrials.gov with clinical trial registration number NCT05088811.

The classification of gastric antral vascular ectasia in cirrhotic patients by Versatile Intelligent Staining Technology.

Background: Portal hypertensive gastropathy (PHG) and gastric antral vascular ectasia (GAVE) are two different pathologies that cause bleeding in cirrhotic patients. These two pathologies are still difficult to be distinguished by white light endoscopy (conventional), as they both appear as red spots in the gastric antral mucosa in the case of severe PHG. The aim of our study was to assess the efficacy of Versatile Intelligent Staining Technology (VIST) in comparison to histopathology in the diagnosis and classification of GAVE. Methods: A cross-sectional study included 50 patients with liver cirrhosis recruited from Alexandria Main University Hospital. Patients with connective tissue diseases and chronic kidney disease were excluded. All patients were examined by both conventional white light endoscopy (WLE) and image enhancement technology (VIST) using Sonoscape HD500 endoscope. GAVE was diagnosed as tortuous columns of ectatic vessels in the gastric antrum. Histopathological examination was used as the standard tool for the diagnosis of GAVE. Results: A total of 50 patients were included, 28 patients (56 %) were diagnosed as GAVE by pathology vs 22 (44 %) as non-GAVE. Twenty-three of 28 (78.6 %) cases of GAVE were detected by VIST. VIST had superior sensitivity than WLE in the detection of GAVE, 82.1 % vs 7.1 %, while WLE had higher specificity 95.5 % vs 59.1 % by VIST. There was statistical significance between VIST and pathology in the diagnosis of GAVE, p<0.035, but no statistical significance between WLE and pathology. VIST has identified two types of GAVE: focal in 12/28 cases and diffuse in 11/28, and five were not diagnosed by VIST. Conclusions: Versatile Intelligent Staining Technology could be used as an alternative tool to histopathological diagnosis of GAVE. GAVE can present as a focal group of ectatic vessels which adds a new class to GAVE classification that was previously misdiagnosed.