Evaluation of serum endoglin as noninvasive marker in hepatocellular carcinoma

• Published in: The Egyptian journal of internal medicine Vol. 27; no. 1; pp. 15 - 20
• Main Authors: Mohamed, Rehab A., Maghraby, Hend M., Abd El Salam, Eman M., Nageb, Hala M., Ahmad, Eman E., Mohamed, Nagwa A.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 2015; Springer Nature B.V
• Subjects: Growth factors; Hepatitis C; Internal Medicine; Liver cancer; Liver cirrhosis; Medicine & Public Health; Original Article; hepatitis C virus; serum endoglin; serum a-fetoprotein; hepatocellular carcinoma
• ISSN: 1110-7782; 2090-9098
• DOI: 10.4103/1110-7782.155832

Introduction
Hepatitis C viral (HCV) infection is a major risk factor for liver cirrhosis, liver failure, and hepatocellular carcinoma (HCC). A number of laboratory-based methods has been developed for the noninvasive diagnostic evaluation of HCC. Endoglin (CD105) is a homodimeric membrane glycoprotein expressed on endothelial cells that can bind to transforming growth factor-b1 and transforming growth factor-b3.
Aim of the study
The aim of this study was to evaluate the diagnostic value of endoglin and a-fetoprotein (AFP) in patients with chronic HCV infection with and without HCC.
Patients and methods
A total of 50 HCV patients were chosen and divided into two patients groups, group I (26 cirrhotic patients) and group II (24 HCC patients), and compared with group III (10 healthy volunteers) as controls. For all participants, thorough clinical examination, blood picture, liver function tests, HCV antibody, AFP, and serum endoglin were performed. Abdominal ultrasound, abdominal triphasic computed tomographic scan, and liver biopsy for those diagnosed HCC by triphasic computed tomography were performed.
Results
We found highly significant increase in serum endoglin in HCV patients with HCC (group III) compared with HCV patients with liver cirrhosis (group I) and controls (group III). There was significant positive correlation between serum endoglin and aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, total bilirubin, and AFP. In addition, there was significant negative correlation between serum endoglin and hemoglobin, albumin, and prothrombin concentration. The cutoff value for serum AFP for which HCC is suspected was greater than 2.17 ng/ml with sensitivity 98% and specificity 80%, whereas the cutoff value for serum endoglin was greater than 6.05 ng/ml with sensitivity 98% and specificity 90%.
Conclusion
Serum endoglin surpassed serum AFP due to the higher degree of diagnostic specificity, as well as sensitivity. Serum endoglin showed a better diagnostic performance and proved to be more reliable as a tumor marker for HCC. Serum endoglin may be used with serum AFP as complementary biomarker as noninvasive technique to aid diagnosis of HCC.