Serum Soluble CD25 in Hepatocellular Carcinoma, Shall We Able to Change the Natural History?

Abstract

Background: Although hepatocellular carcinoma (HCC) is one of the most common malignancy related mortality worldwide, it can be curable if detected in early stages. Axiomatically, emergence of a new marker for early prediction of HCC could enable to apply the proper treatment strategy early in the course of the disease and therefore ameliorates the outcome. Aim: To evaluate the performance of serum soluble CD25 (sCD25) in the prediction of early HCC and compare it to α-fetoprotein (AFP); the classical biomarker of HCC. Methods: Serum levels of sCD25 and AFP were measured in three groups of population; HCC group (40 patients), cirrhosis without HCC control group (20 patients) and healthy control group (20 patients). HCC group contained 20 early and 20 late stage patients according to Tumor Lymph Node Metastasis (TNM) staging system (stage I/II and III/IV respectively). Levels of both biomarkers were compared in all groups. Predictive yield of both biomarkers for early HCC was evaluated using ROC curve analysis. Results: Level of sCD25 was significantly higher in patients with HCC than in both cirrhotic controls and healthy controls (P<0.0001and 0.013 respectively). For the presence of HCC, sensitivity and specificity of sCD25 were 90% and 84.2% respectively at a cut-off value of 7 ng/ml (AUC=0.969; P<0.0001). For prediction of early HCC in patients with cirrhosis, the optimal sCD25 cutoff level was 7.15 ng/ml with sensitivity and specificity of 90% and 60% respectively (AUC=0.717; P=0.019) while sensitivity and specificity of AFP were 70% and 85% respectively at a cut-off value of 9.85 ng/ml (AUC=0.781; P=0.002) in the same settings. Conclusion: sCD25 seems to be a reliable biomarker for early detection of HCC and therefore could enhance the outcome.