Diagnostic Value of Serum GPC3 and Survivin in Hepatocellular Carcinoma (HCC) Individuals Attending Teaching Hospitals in Lagos, Nigeria

Abstract

Background: Hepatocellular carcinoma (HCC), the major form of liver cancer, is a significant health threat, especially in endemic areas like Nigeria, due to rising incidence and poor prognosis. Aim: This study aimed to evaluate and compare serum levels of glypican-3 (GPC3), survivin, alpha-fetoprotein (AFP) and lactate dehydrogenase (LDH) in hepatitis B (HBV), cirrhosis and HCC patients in Lagos, Nigeria, to explore their potential roles as diagnostic biomarkers for HCC, especially in HBV patients. Methodology: This observational case-control study was conducted at Lagos University Teaching Hospital, Lagos State University Teaching Hospital, College of Medicine (University of Lagos) and National Institute of Medical Research, Yaba, Lagos, between August 2018 and February 2023. The study recruited 500 participants (371 males, 129 females; age range 18-75 years) with HCC, Cirrhosis and HBV into the study, with age and sex-matched controls. Protein expression was quantified by Enzyme-Linked Immunosorbent Assay (ELISA). Data were analysed using GraphPad Prism 8.0 and SPSS v.25. P-value <0.05 was considered significant. Results: Serum GPC3 and survivin levels were significantly reduced in HBV patients compared to healthy controls (P=.0003, .001), but showed no significant difference between HCC/cirrhosis and controls (P>0.05). A statistically significant difference between their levels in HBV and HCC/ cirrhosis was however recorded (P>0.001). There was no significant difference in LDH levels between controls and HBV, and between cirrhosis and HCC groups. However, obvious increases in LDH were observed in cirrhosis and HCC groups compared to controls. AFP levels increased significantly across the groups, with the highest levels observed in the HCC group.  The sensitivity, specificity and area under the receiver operating characteristic curve of GPC3 and survivin were significantly higher in differentiating HCC from HBV patients than HCC from healthy controls. Conclusion: Survivin, GPC3, and LDH are poor diagnostic markers for HCC as compared to AFP in the investigated population but may be used to manage HBV infection.