Diagnostic Value of Serum Syndecan-1 in Hepatocellular Carcinoma Associated with Hepatitis C virus in Egyptian Patients

Abstract

Hepatocellular carcinoma (HCC) can benefit from tumor biomarkers’ diagnostic, therapeutic, and prognostic capabilities. There is a need for the use of accurate, rapid and inexpensive tumor marker with ultrasonography and computer tomography in appropriate diagnosis of HCC.

The present study was designed to investigate the potential role of syndecan-1 as a diagnostic and prognostic, non-invasive biomarker for HCC. Also, to assess its accuracy, sensitivity and specificity in comparison with the usual recommended biomarker α-fetoprotein (AFP).

This study is a cross sectional case–control study. The study included 45 patients with HCC associated with chronic HCV infection. In addition, 20 healthy subjects were included as a control group. AFP and syndecan-1were determined by enzyme immunoassay.

Syndecan-1 serum level showed significantly marked elevation in HCC patients compared to control subjects (P<0.001). Analytical correlation study revealed highly significant positive correlation between syndecan-1 serum level with older patient  over 55 years old , larger tumor size more than 2.5 cm and the presence of ascites ( P<0.001). Moreover, there was statistically significant increase in syndecan-1 levels in advanced Child-Pugh classifications (P<0.001). For determination the best diagnostic performance level of syndecan-1 represented by cut off value, receiver operative curve was drawn (ROC). Cut off point level were 4241 pg/ml with sensitivity 99.8% and 85% specificity.

We conclude that syndecan-1 is an accurate biomarker in the diagnosis and prognosis of HCC, since its level is elevated in HCC patients and correlated with tumor size, patients over 55 years old, larger tumor size more than 2.5 cm, the presence of ascites and different stages of HCC. Further studies on large groups of patients are required to validate these results.

Keywords: HCC, Syndecan-1, α-fetoprotein