Serum soluble urokinase plasminogen activator receptor as a screening test for the early diagnosis of hepatocellular carcinoma

Background & Aims Early detection of hepatocellular carcinoma (HCC) before imaging signs appear remains an unmet medical need. Former publications suggest that soluble urokinase plasminogen activator receptor (suPAR) is a non‐specific cancer marker. suPAR was validated for the detection of patie...

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Published in:Liver international 2015-02, Vol.35 (2), p.601-607
Main Authors: Chounta, Athina, Ellinas, Christofer, Tzanetakou, Vassiliki, Pliarhopoulou, Fani, Mplani, Virginia, Oikonomou, Angelos, Leventogiannis, Kostantinos, Giamarellos-Bourboulis, Evangelos J.
Format: Article
Language:English
Subjects:
Biomarkers, Tumor - blood
Carcinoma, Hepatocellular - diagnosis
Carcinoma, Hepatocellular - epidemiology
early diagnosis
hepatocellular carcinoma
Humans
Liver Neoplasms - diagnosis
Liver Neoplasms - epidemiology
Predictive Value of Tests
Prospective Studies
Receptors, Urokinase Plasminogen Activator - blood
Sensitivity and Specificity
suPAR
Survival Analysis
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Summary:Background & Aims Early detection of hepatocellular carcinoma (HCC) before imaging signs appear remains an unmet medical need. Former publications suggest that soluble urokinase plasminogen activator receptor (suPAR) is a non‐specific cancer marker. suPAR was validated for the detection of patients at risk for HCC. Methods After an initial training set in 23 patients with extreme disease phenotypes, a prospective test set was conducted in which 267 patients without any imaging signs of HCC were followed up for 7 years. Patients were divided into low risk and high risk for the development of HCC by the EASL criteria. suPAR was measured at the beginning of follow‐up. All patients underwent liver biopsy to define staging of fibrosis. The primary study endpoint was to define a cut‐off among high‐risk patients by the EASL criteria that can early discriminate those at real risk for HCC. Results The training set showed that suPAR was significantly greater in patients with HCC even in the absence of underlying cirrhosis compared with patients with minimal liver inflammation because of fatty deposition. The test set showed that among the high‐risk EASL subgroup, suPAR more than 9.56 ng/ml had sensitivity 76.0%, specificity 90.4%, positive predictive value 54.3% and negative predictive value 96.2% for the development of HCC (odds ratio: 29.88, P 
ISSN:1478-3223
1478-3231
DOI:10.1111/liv.12705