Enhanced detection of early hepatocellular carcinoma by serum SELDI-TOF proteomic signature combined with alpha-fetoprotein marker

Lei Chen*, David W.Y. Ho, Nikki P.Y. Lee, Stella Sun, Brian Lam, Kwong Fai Wong, Xin Yi, George K. Lau, Eddy W.Y. Ng, Terence C.W. Poon, Paul B.S. Lai, Zongwei Cai, Jirun Peng, Xisheng Leng, Ronnie T.P. Poon, John M. Luk

*Corresponding author for this work

Research output: Contribution to journalJournal articlepeer-review

45 Citations (Scopus)

Abstract

Background: Biomarkers for accurate diagnosis of early hepatocellular carcinoma (HCC) are limited in number and clinical validation. We applied SELDI-TOF-MS ProteinChip technology to identify serum profile for distinguishing HCC and liver cirrhosis (LC) and to compare the accuracy of SELDI-TOF-MS profile and alpha-fetoprotein (AFP) level in HCC diagnosis. Patients and Methods: Serum samples were obtained from 120 HCC and 120 LC patients for biomarker discovery and validation studies. ProteinChip technology was employed for generating SELDI-TOF proteomic features and analyzing serum proteins/peptides. Results: A diagnostic model was established by CART algorithm, which is based on 5 proteomic peaks with m/z values at 3324, 3994, 4665, 4795, and 5152. In the training set, the CART algorithm could differentiate HCC from LC subjects with a sensitivity and specificity of 98% and 95%, respectively. The results were assessed in blind validation using separate cohorts of 60 HCC and 60 LC patients, with an accuracy of 83% for HCC and 92% for LC patients. The diagnostic odd ratio (DOR) indicated that SELDI-TOF proteomic signature could achieve better diagnostic performance than serum AFP level at a cutoff of 20 ng/mL (AFP20) (92.72 vs 9.11), particularly superior for early-stage HCC (87% vs 54%). Importantly, a combined use of both tests could enhance the detection of HCC (sensitivity, 95%; specificity, 98%; DOR, 931). Conclusion: Serum SELDI-TOF proteomic signature, alone or in combination with AFP marker, promises to be a good tool for early diagnosis and/screening of HCC in at-risk population with liver cirrhosis.

Original languageEnglish
Pages (from-to)2518-2525
Number of pages8
JournalAnnals of Surgical Oncology
Volume17
Issue number9
DOIs
Publication statusPublished - Sept 2010

Scopus Subject Areas

  • Surgery
  • Oncology

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