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Golgi protein 73 versus alpha fetoprotein as a marker for hepatocellular carcinoma

Objective The aim of this work was to assess the clinical utility of Golgi protein 73 (GP73) among Egyptian hepatocellular carcinoma (HCC) patients in comparison with α-fetoprotein (AFP). In addition, the level of GP73 was evaluated after surgical resection of HCC. Background Serum Golgi protein 73 (sGP73) is a promising biomarker for detection of HCC. Patients and methods This study included 76 patients; 38 of them had proved HCC (10 of them were followed up after hepatectomy to detect the level of GP73 after treatment), 25 patients had chronic liver diseases (CLDs) and 13 apparently healthy individuals were considered as controls. Clinical examination, abdominal ultrasonography and triphasic computed tomography for focal lesion were performed. Liver function tests were performed using Synchron Cx9 ALX Clinical Autoanalyzer, serum AFP was measured using ELISA method and hepatitis markers and GP73 were determined by ELISA kit for GP73. Results There was highly statistically significant difference in GP73 between HCC and the control group and also between HCC and the CLD group. Moreover, GP73 is significantly lower after hepatectomy. For discrimination of HCC from healthy control, receiver operating characteristic curve showed that sGP73 levels had area under the receiver operating characteristic (AUROC) curve of 0.89 [95% confidence interval (CI) 0.81-0.98)] and sensitivity of 76.3% and specificity of 92.3% at a cutoff point 192 ng/l, whereas AFP had AUROC curve of 0.83 (95% CI 0.71-0.95) and sensitivity of 73.7% and specificity of 61.5% at a cutoff point 10.5 ng/ml. For discrimination of HCC from CLD, receiver operating characteristic curve showed that the sGP73 levels had the AUROC curve of 0.88 (95% CI 0.79-0.96) and sensitivity of 76.3% and specificity of 84% at a cutoff point 195 ng/l, whereas AFP had AUROC curve of 0.83 (95% CI 0.72-0.93) and sensitivity of 73.7% and specificity of 68% at a cutoff point 10.5 ng/ml. Conclusion GP73 expression is highly increased in HCC patients. Its diagnostic performance is superior to that of AFP and is a useful marker for follow-up of HCC patients after surgical hepatectomy.