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Authors Wang Y, Yu W, He M, Huang Y, Wang M, Zhu J
Received 1 October 2018
Accepted for publication 8 December 2018
Published 31 December 2018 Volume 2019:12 Pages 359—364
DOI https://doi.org/10.2147/OTT.S189425
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Andrew Yee
Peer reviewer comments 2
Editor who approved publication: Dr Federico Perche
Background: Alpha-fetoprotein
(AFP) is the most commonly applied biomarker for diagnosis of hepatocellular
carcinoma (HCC), but the low sensitivity and specificity limit its clinical application.
Cytoskeleton-associated protein 4 (CKAP4) is a novel oncogenic protein involved
in the development and progression of HCC. This study aimed to evaluate whether
measurement of circulating CKAP4 could improve diagnostic accuracy for HCC.
Methods: We
analyzed data for patients with HCC, chronic hepatitis B infection, and
cirrhosis and healthy controls (n=100 in each group), recruited from two
centers between July 2013 and December 2015. Circulating levels of CKAP4 were
measured with commercial enzyme-linked immunosorbent assay kits. Receiver
operating characteristics were used to evaluate diagnostic accuracy.
Results: Serum
concentrations of CKAP4 were significantly elevated in the HCC group, in
comparison with the three control groups (all P <0.001). The
combined biomarker panel (AFP and CKAP4), created by binary logistic
regression, presented better performance (area under the curve [AUC] 0.936, 95%
CI [0.908–0.965], sensitivity 0.800, specificity 0.963) than AFP (AUC 0.875
[0.835–0.914], sensitivity 0.930, specificity 0.430, P =0.001) or CKAP4
(AUC 0.821 [0.776–0.866], sensitivity 0.790, specificity 0.670, P <0.001) alone
to identify HCC, even though CKAP4 alone was not better than AFP (P =0.093).
Furthermore, the combined panel also presented a better performance even in
identifying early HCC (AUC 0.922 [0.833–0.961]).
Conclusion: Serum
CKAP4 is a novel biomarker for HCC, and it could complement AFP in improving
diagnostic accuracy.
Keywords: alpha-fetoprotein,
biomarker, cytoskeleton-associated protein 4, hepatocellular carcinoma