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Subject Area

Clinical Pathology

Article Type

Original Study

Abstract

Background Hepatocellular carcinoma (HCC) is a leading cause of cancer death. Because alpha-fetoprotein (AFP) has low diagnostic accuracy, we studied a novel diagnostic biomarker for HCC diagnosis. Objectives To evaluate plasma level of highly upregulated in liver cancer (HULC) long noncoding RNA as a biomarker for HCC diagnosis. Patients and methods This case–control study included 75 participants in three groups: patients with HCC on top of hepatitis C virus (group I), hepatitis C virus cirrhotic patients (group II), and healthy controls (group III). Clinical examination, radiological and laboratory investigations were done for all cases. HULC was measured by real-time quantitative PCR. AFP and viral markers were determined by enzyme immunoassay based on electro-chemiluminescence. Liver function tests were done on Cobas 6000 analyzer. Results The study included 75 participants in three matched groups of age and sex (no of each group = 25 participants). The parameters that showed significant difference (P ≤ 0.05) by univariate analysis were model for end-stage liver disease, Child–Pugh, lower limb edema, ascites, international normalized ratio, alanine aminotransferase, aspartate aminotransferase, total bilirubin, creatinine, AFP, HULC level, albumin, and platelet count. However, multivariate analysis demonstrated that high AFP and HULC levels were the parameters that could independently diagnose HCC. The mean ± SD of HULC of the three groups was 2.1 ± 1.6, 0.5 ± 0.4, and 0.1 ± 0.05, respectively. HULC level at cutoff point of 1.08 ng/ml had sensitivity of 72% and specificity of 92% to diagnose HCC. AFP at cutoff point of 25.55 ng/ml had sensitivity of 68% and specificity of 88%. HULC level was significantly correlated with HCC tumor size, tumor number, and presence of portal vein thrombosis. Conclusion HULC level could act as a novel biomarker for HCC diagnosis.

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