medigraphic.com
Órgano Oficial de la Asociación Mexicana de Hepatología

2019, Number 1

<< Back Next >>

Ann Hepatol 2019; 18 (1)

Performance of Serum Glypican 3 in Diagnosis of Hepatocellular Carcinoma: A meta-analysis

Xu D, Su C, Sun L, Gao Y, Li Y

Language: English
References: 45
Page: 58-67
PDF size: 170.78 Kb.


ABSTRACT

Introduction and aim. Serum glypican-3 (GPC3) has been explored as a non-invasive biomarker of hepatocellular carcinoma (HCC). However, controversy remains on its diagnostic accuracy. Therefore, we aimed to conduct a systematic review and metaanalysis to evaluate the differential diagnostic accuracy of serum GPC3 between HCC and liver cirrhosis (LC) cases. Material and methods. After the strict filtering and screening of studies from NCBI, PUBMED, Clinical Trials, Cochrane library, Embase, Prospero and Web of Science databases, 11 studies were selected. All studies provided the sensitivity and specificity of GPC3 and the alpha-fetoprotein (AFP) in the HCC and LC diagnosis. The sensitivity and specificity, and the area under the receiver operating characteristic curve (AUC) were determined and compared between GPC3 and AFP, which was set as a positive control. Results. Pooled sensitivity (95% CI) and specificity (95% CI) were 0.55 (0.52-0.58) and 0.58 (0.54-0.61) for GPC3, 0.54 (0.51-0.57) and 0.83 (0.80-0.85) for AFP, and 0.85 (0.81-0.89) and 0.79 (0.73-0.84) for GPC3 + AFP, respectively. The AUCs of GPC3, AFP and GPC3 + AFP were 0.7793, 0.7867 and 0.9366, respectively. GPC3 had a nearly similar sensitivity as AFP, while the specificity and AUC of GPC3 was lower than that of AFP. The combination of GPC3 and AFP yielded a better sensitivity and AUC than GPC3 or AFP. Conclusion. Serum GPC3 is inferior to AFP in the differential diagnosis between HCC and LC. However, the combination of GPC3 and AFP exhibited a much better performance.


REFERENCES

  1. Maluccio M, Covey A. Recent progress in understanding, diagnosing, and treating hepatocellular carcinoma. CA: a Cancer Journal for Clinicians 2012; 62: 394-9.

  2. Zhao YS, Wang M, Cui CY, Zhang L, Liao F, Li HC, Wu X. Significance of combined tests of serum golgi glycoprotein 73 and other biomarkers in diagnosis of small primary hepatocellular carcinoma. Cancer Biomark 2015; 15: 677-83.

  3. Yu JP, Xu XG, Ma RJ, Qin SN, Wang CR, Wang XB, Li M, et al. Development of a Clinical Chemiluminescent Immunoassay for Serum GPC3 and Simultaneous Measurements Alone With AFP and CK19 in Diagnosis of Hepatocellular Carcinoma. J Clin Lab Anal 2015; 29: 85-93.

  4. Song DS, Bae SH. Changes of guidelines diagnosing hepatocellular carcinoma during the last ten-year period. Clin Molec Hepatol 2012; 18: 258-67.

  5. Jiang ZW, Jiang XF, Chen SM, Lai YX, Wei XR, Li BH, Lin S, et al. Anti-GPEC3-CAR T Cells Suppress the Growth of Tumor Cells in Patient-Derived Xenogratfts of Hepatocelluar Carcinoma. Front Immunol 2017; 7: 690

  6. Zhu XT, Yuan JH, Zhu TT, Li YY, Cheng XY. Long noncoding RNA glypican 3 (GPC3) antisense transcript 1 promotes hepatocellular carcinoma progression via epigenetically activating GPC3. Febs Journal 2016; 283: 3739-54.

  7. Sun B, Huang Z, Wang B, Yu YL, Lin SH, Luo L, Wang Y, et al. Significance of Glypican-3 (GPC3) Expression in Hepatocellular Cancer Diagnosis. Med Sci Monit 2017; 23: 850-5.

  8. Jia XB, Gao YT, Zhai DK, Liu J, Cai JJ, Wang YJ, Jing L, et al. Assessment of the Clinical Utility of Glypican 3 as a Serum Marker for the Diagnosis of Hepatocellular Carcinoma. Technol Cancer Res Treat 2016; 15: 780-6.

  9. Jeon Y, Jang ES, Choi YS, Kim JW, Jeong SH. Glypican-3 level assessed by the enzyme-linked immunosorbent assay is inferior to alpha-fetoprotein level for hepatocellular carcinoma diagnosis. Clin Molec Hepatol 2016; 22: 359-65.

  10. Attallah AM, El-Far M, Omran MM, Abdelrazek MA, Attallah AA, Saeed AM, Farid K, et al. GPC-HCC model: a combination of glybican-3 with other routine parameters improves the diagnostic efficacy in hepatocellular carcinoma. Tumour biology: the Journal of the International Society for Oncodevelopmental Biology and Medicine 2016; 37: 12571-7.

  11. Ozkan H, Erdal H, Kocak E, Tutkak H, Karaeren Z, Yakut M, Köklü S. Diagnostic and Prognostic Role of Serum Glypican 3 in Patients With Hepatocellular Carcinoma. J Clin Lab Anal 2011; 25: 350-3.

  12. Tangkijvanich P, Chanmee T, Komtong S, Mahachai V, Wisedopas N, Pothacharoen P, Kongtawelert P. Diagnostic role of serum glypican-3 in differentiating hepatocellular carcinoma from non-malignant chronic liver disease and other liver cancers. J Gastroenterol Hepatol 2010; 25: 129-37.

  13. Yang SL, Fang X, Huang ZZ, Liu XJ, Xiong ZF, Liu P, Yao HY, et al. Can serum glypican-3 be a biomarker for effective diagnosis of hepatocellular carcinoma? A meta-analysis of the literature. Dis Markers 2014; 2014: 127831.

  14. Jia X, Liu J, Gao Y, Huang Y, Du Z. Diagnosis accuracy of serum glypican-3 in patients with hepatocellular carcinoma: a systematic review with meta-analysis. Arch Med Res 2014; 45: 580-8.

  15. Xu C, Yan Z, Zhou L, Wang Y. A comparison of glypican-3 with alpha-fetoprotein as a serum marker for hepatocellular carcinoma: a meta-analysis. J Cancer Res Clin Oncol 2013; 139: 1417-24.

  16. Liu JW, Zuo XL, Wang S. Diagnosis accuracy of serum Glypican- 3 level in patients with hepatocellular carcinoma and liver cirrhosis: a meta-analysis. Eur Rev Med Pharmacol Sci 2015; 19: 3655-73.

  17. Liu XF, Hu ZD, Liu XC, Cao Y, Ding CM, Hu CJ. Diagnostic accuracy of serum glypican-3 for hepatocellular carcinoma: a systematic review and meta-analysis. Clin Biochem 2014; 47: 196-200.

  18. Fu WY, Lu HY, Li L, Wu KF, Li YP, Liu Y, Hu J, et al. Glypican- 3 versus alpha-fetoprotein as a biomarker for hepatocellular carcinoma: A diagnostic meta-analysis. Biocell 2015; 39: 25-31.

  19. Badr EAE, Korah TE, Ghani AA, El-Sayed S, Badr S. Role of serum glypican-3 in the diagnosis and differentiation of small hepatocellular carcinoma from hepatitis-C virus cirrhosis. Alexandria J Med 2014; 50: 221-6.

  20. Abd El Gawad IA, Mossallam GI, Radwan NH, Elzawahry HM, Elhifnawy NM. Comparing prothrombin induced by vitamin K absence-II (PIVKA-II) with the oncofetal proteins glypican- 3, Alpha feto protein and carcinoembryonic antigen in diagnosing hepatocellular carcinoma among Egyptian patients. J Egypt Natl Canc Inst 2014; 26: 79-85.

  21. Wang W, Zhao LJ, Wang Y, Tao QY, Feitelson MA, Zhao P, Ren H, et al. Application of HBx-induced anti-URGs as earlywarning biomarker of cirrhosis and HCC. Cancer Biomark 2012; 11: 29-39.

  22. Gomaa AHO, Aboraia G, Attia H, Elezawy H, Nafie E, Elbaz S. The diagnostic value of peripheral blood glypican-3 in patients with hepatocellular carcinoma. World J Med Sci 2012; 7: 105-12.

  23. Liu H, Li P, Zhai Y, Qu CF, Zhang LJ, Tan YF, Li N, et al. Diagnostic value of glypican-3 in serum and liver for primary hepatocellular carcinoma. World J Gastroenterol 2010; 16: 4410-5.

  24. Beale G, Chattopadhyay D, Gray J, Stewart S, Hudson M, Day C, Trerotoli P, et al. AFP, PIVKAII, GP3, SCCA-1 and follisatin as surveillance biomarkers for hepatocellular cancer in non-alcoholic and alcoholic fatty liver disease. Bmc Cancer 2008; 8.

  25. Hippo Y, Watanabe K, Watanabe A, Midorikawa Y, Yamamoto S, Ihara S, Tokita S, et al. Identification of soluble NH2-terminal fragment of glypican-3 as a serological marker for early-stage hepatocellular carcinoma. Cancer Res 2004; 64: 2418-23.

  26. Yu J, Ma Q, Zhang B, Ma R, Xu X, Li M, Xu W, et al. Clinical application of specific antibody against glypican-3 for hepatocellular carcinoma diagnosis. Science China Life Sciences 2013; 56: 234-9.

  27. Zhou R, Pan QJ, Wu K, Li R. Distribution and characterization of glypican-3 in hepatocelluar carcinoma. Int J Clin Exp Pathol 2016; 9: 8631-3.

  28. Sang W, Miao N, Cui WL, Li XX, Abulajiang G, Zhang W, Li Q, et al. Value of the combined detection arginase-1 and glypican- 3 expression in distinguishing hepatocellular carcinoma from metastatic tumors. Int J Clin Exp Pathol 2016; 9: 7748-54.

  29. Nguyen TB, Roncalli M, Di Tommaso L, Kakar S. Combined use of heat-shock protein 70 and glutamine synthetase is useful in the distinction of typical hepatocellular adenoma from atypical hepatocellular neoplasms and well-differentiated hepatocellular carcinoma. Mod Pathol 2016; 29: 283-92.

  30. Abou-Alfa GK, Yen CJ, Hsu CH, O’Donoghue J, Beylergil V, Ruan S, Pandit-Taskar N, et al. Phase Ib study of codrituzumab in combination with sorafenib in patients with non-curable advanced hepatocellular carcinoma (HCC). Cancer Chemother Pharmacol 2017; 79: 421-9.

  31. Abou-Alfa GK, Puig O, Daniele B, Kudo M, Merle P, Park JW, Ross P, et al. Randomized phase II placebo controlled study of codrituzumab in previously treated patients with advanced hepatocellular carcinoma. J Hepatol 2016; 65: 289-95.

  32. Ikeda M, Ohkawa S, Okusaka T, Mitsunaga S, Kobayashi S, Morizane C, Suzuki I, et al. Japanese phase I study of GC33, a humanized antibody against glypican-3 for advanced hepatocellular carcinoma. Cancer science 2014; 105: 455-62.

  33. Sawada Y, Yoshikawa T, Nobuoka D, Shirakawa H, Kuronuma T, Motomura Y, Mizuno S, et al. Phase I trial of a glypican- 3-derived peptide vaccine for advanced hepatocellular carcinoma: immunologic evidence and potential for improving overall survival. Clinical Cancer Research: an Official Journal of the American Association for Cancer Research 2012; 18: 3686-96.

  34. Filmus J, Selleck SB. Glypicans: proteoglycans with a surprise. J Clin Invest 2001; 108: 497-501.

  35. Chen IP, Ariizumi S, Nakano M, Yamamoto M. Positive glypican- 3 expression in early hepatocellular carcinoma predicts recurrence after hepatectomy. J Gastroenterol 2014; 49: 117-25.

  36. Chen M, Li GH, Yan J, Lu XZ, Cui JW, Ni ZX, Cheng W, et al. Reevaluation of glypican-3 as a serological marker for hepatocellular carcinoma. Clin Chim Act 2013; 423: 105-11.

  37. Ikuta Y, Nakatsura T, Kageshita T, Fukushima S, Ito S, Wakamatsu K, Baba H, et al. Highly sensitive detection of melanoma at an early stage based on the increased serum secreted protein acidic and rich in cysteine and glypican-3 levels. Clin Cancer Res 2005; 11: 8079-88.

  38. Ohno A, Yorita K, Haruyama Y, Kondo K, Kato A, Ohtomo T, Kawaguchi M, et al. Aberrant expression of monocarboxylate transporter 4 in tumour cells predicts an unfavourable outcome in patients with hepatocellular carcinoma Akinobu Ohno. Liver Int 2014; 34: 942-52.

  39. Xiao WK, Qi CY, Chen D, Li SQ, Fu SJ, Peng BG, Liang LJ. Prognostic significance of glypican-3 in hepatocellular carcinoma: a meta-analysis. Bmc Cancer 2014; 14: 104.

  40. Li J, Gao JZ, Du JL, Wei LX. Prognostic and clinicopathological significance of glypican-3 overexpression in hepatocellular carcinoma: A meta-analysis. World J Gastroenterol 2014; 20: 6336-44.

  41. Yeon JE, Suh SJ, Lee SJ, Yoon EL, Kang K, Yoo YJ, Lee HJ, et al. Clinical utility of plasma glypican-3 and osteopontin as biomarkers of hepatocellular carcinoma. Gut and Liver 2014; 8: 177-85.

  42. Zhang QY, Xiao Q, Lin Z, Ying XT, Li ZJ, Lin JM. Development of a competitive radioimmunoassay for glypican-3 and the clinical application in diagnosis of hepatocellular carcinoma. Clinical Biochemistry 2010; 43: 1003-8.

  43. Nassar A, Cohen C, Siddiqui MT. Utility of glypican-3 and survivin in differentiating hepatocellular carcinoma from benign and preneoplastic hepatic lesions and metastatic carcinomas in liver fine-needle aspiration biopsies. Diagnostic Cytopathology 2009; 37: 629-35.

  44. Yasuda E, Kumada T, Toyoda H, Kaneoka Y, Maeda A, Okuda S, Yoshimi N, et al. Evaluation for clinical utility of GPC3, measured by a commercially available ELISA kit with Glypican- 3 (GPC3) antibody, as a serological and histological marker for hepatocellular carcinoma. Hepatology Research: the Official Journal of the Japan Society of Hepatology 2010; 40: 477-85.

  45. Wang Y, Yang H, Xu H, Lu X, Sang X, Zhong S, Huang J, et al. Golgi protein 73, not Glypican-3, may be a tumor marker complementary to alpha-Fetoprotein for hepatocellular carcinoma diagnosis. J Gastroenterol Hepatol 2014; 29: 597- 602.




2020     |     www.medigraphic.com