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Serum thioredoxin is a diagnostic marker for hepatocellular carcinoma.

Li J, Cheng ZJ, Liu Y, Yan ZL, Wang K, Wu D, Wan XY, Xia Y, Lau WY, Wu MC, Shen F - Oncotarget (2015)

Bottom Line: Among AFP-negative patients with very early HCC, 18 (69.2%) of 26 had positive thioredoxin results.Our results indicate that serum thioredoxin complements measurement of AFP in the diagnosis of HCC, especially in very early disease.Combined model (thioredoxin and AFP) showed a significantly greater discriminatory ability as compared with those markers alone.

View Article: PubMed Central - PubMed

Affiliation: Department of Hepatic Surgery, The Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China.

ABSTRACT
Here we found that serum levels of thioredoxin were increased in patients with hepatocellular carcinoma (HCC). The optimum diagnostic cutoff for thioredoxin was 20.5 ng/mL (area under curve [AUC] 0.946 [95% CI 0.923-0.969] in the training cohort; 0.941 [0.918-0.963] in the validation cohort). High serum concentrations of thioredoxin differentiated HCC from chronic liver diseases and cirrhosis (0.901 [0.875-0.923] in the training cohort; 0.906 [0.870-0.925] in the validation cohort). Furthermore, a higher proportion of patients with very early HCC had positive results for thioredoxin than for alpha-Fetoprotein (AFP) (73.7% VS.31.6%; P < 0.0001). Among AFP-negative patients with very early HCC, 18 (69.2%) of 26 had positive thioredoxin results. Our results indicate that serum thioredoxin complements measurement of AFP in the diagnosis of HCC, especially in very early disease. Combined model (thioredoxin and AFP) showed a significantly greater discriminatory ability as compared with those markers alone.

No MeSH data available.


Related in: MedlinePlus

Diagnostic performance of serum TRX and AFP as diagnostic markers for HCC and very early HCC evaluated by the ROC curve(a) ROC curve for TRX, AFP, or both for all patients with HCC versus all controls in the training cohort. (b) ROC curve for TRX, AFP, or both for all patients with HCC versus all controls in the validation cohort. (c) ROC curve for TRX, AFP, or both for patients with very early HCC versus all controls in the training cohort. (d) ROC curve for TRX, AFP, or both for patients with very early HCC versus all controls in the validation cohort. ROC = receiver operating characteristics. CLD = chronic liver diseases. LC = liver cirrhosis. HCC = hepatocellular carcinoma; TRX = thioredoxin.
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Figure 2: Diagnostic performance of serum TRX and AFP as diagnostic markers for HCC and very early HCC evaluated by the ROC curve(a) ROC curve for TRX, AFP, or both for all patients with HCC versus all controls in the training cohort. (b) ROC curve for TRX, AFP, or both for all patients with HCC versus all controls in the validation cohort. (c) ROC curve for TRX, AFP, or both for patients with very early HCC versus all controls in the training cohort. (d) ROC curve for TRX, AFP, or both for patients with very early HCC versus all controls in the validation cohort. ROC = receiver operating characteristics. CLD = chronic liver diseases. LC = liver cirrhosis. HCC = hepatocellular carcinoma; TRX = thioredoxin.

Mentions: A ROC curve was plotted to define the optimal cut-off values, and to identify the sensitivity and specificity of serum thioredoxin and AFP levels in differentiating patients with HCC versus all other conditions. Based on the ROC curve, the optimal cutoff value of serum thioredoxin levels as an indicator for auxiliary diagnosis of HCC was projected to be 20.5 ng/mL, which yielded a sensitivity of 84.3% and a specificity of 91.8%, with the area under the curve at 0.946 (95% CI, 0.923–0.969); Table 3 and Figure 2a. The optimum cutoff value for AFP was 18.5 ng/mL (AUC 0.878, 95% CI: 0.841–0.914, sensitivity 78.4%, specificity of 81.3%). As the sensitivity and specificity were similar to those for the recommended clinical cutoff of 20 ng/mL (80.1% and 85.9%, respectively; P = 0.231), we chose 20 ng/mL as the cutoff value for AFP in this study. Predictive values for thioredoxin and AFP in the diagnosis of HCC are shown in Table 3. Thioredoxin had a better AUROC compared with AFP (P < 0.001), indicating both a higher sensitivity and specificity of thioredoxin compared with AFP in the diagnosis of HCC (Figure 2a). When HCC patients were compared with CLD and LC patients, the AUC for thioredoxin was also larger than that for AFP (0.901, 0.875–0.923 vs. 0.842, 0.821–0.889, P = 0.002; Table 3). Similarly, when HCC patients were compared with LC patients, the AUC for THIOREDOXIN was also larger than that for AFP (0.874, 0.843–0.901 vs. 0.824, 0.801–0.853, P = 0.004).


Serum thioredoxin is a diagnostic marker for hepatocellular carcinoma.

Li J, Cheng ZJ, Liu Y, Yan ZL, Wang K, Wu D, Wan XY, Xia Y, Lau WY, Wu MC, Shen F - Oncotarget (2015)

Diagnostic performance of serum TRX and AFP as diagnostic markers for HCC and very early HCC evaluated by the ROC curve(a) ROC curve for TRX, AFP, or both for all patients with HCC versus all controls in the training cohort. (b) ROC curve for TRX, AFP, or both for all patients with HCC versus all controls in the validation cohort. (c) ROC curve for TRX, AFP, or both for patients with very early HCC versus all controls in the training cohort. (d) ROC curve for TRX, AFP, or both for patients with very early HCC versus all controls in the validation cohort. ROC = receiver operating characteristics. CLD = chronic liver diseases. LC = liver cirrhosis. HCC = hepatocellular carcinoma; TRX = thioredoxin.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4496238&req=5

Figure 2: Diagnostic performance of serum TRX and AFP as diagnostic markers for HCC and very early HCC evaluated by the ROC curve(a) ROC curve for TRX, AFP, or both for all patients with HCC versus all controls in the training cohort. (b) ROC curve for TRX, AFP, or both for all patients with HCC versus all controls in the validation cohort. (c) ROC curve for TRX, AFP, or both for patients with very early HCC versus all controls in the training cohort. (d) ROC curve for TRX, AFP, or both for patients with very early HCC versus all controls in the validation cohort. ROC = receiver operating characteristics. CLD = chronic liver diseases. LC = liver cirrhosis. HCC = hepatocellular carcinoma; TRX = thioredoxin.
Mentions: A ROC curve was plotted to define the optimal cut-off values, and to identify the sensitivity and specificity of serum thioredoxin and AFP levels in differentiating patients with HCC versus all other conditions. Based on the ROC curve, the optimal cutoff value of serum thioredoxin levels as an indicator for auxiliary diagnosis of HCC was projected to be 20.5 ng/mL, which yielded a sensitivity of 84.3% and a specificity of 91.8%, with the area under the curve at 0.946 (95% CI, 0.923–0.969); Table 3 and Figure 2a. The optimum cutoff value for AFP was 18.5 ng/mL (AUC 0.878, 95% CI: 0.841–0.914, sensitivity 78.4%, specificity of 81.3%). As the sensitivity and specificity were similar to those for the recommended clinical cutoff of 20 ng/mL (80.1% and 85.9%, respectively; P = 0.231), we chose 20 ng/mL as the cutoff value for AFP in this study. Predictive values for thioredoxin and AFP in the diagnosis of HCC are shown in Table 3. Thioredoxin had a better AUROC compared with AFP (P < 0.001), indicating both a higher sensitivity and specificity of thioredoxin compared with AFP in the diagnosis of HCC (Figure 2a). When HCC patients were compared with CLD and LC patients, the AUC for thioredoxin was also larger than that for AFP (0.901, 0.875–0.923 vs. 0.842, 0.821–0.889, P = 0.002; Table 3). Similarly, when HCC patients were compared with LC patients, the AUC for THIOREDOXIN was also larger than that for AFP (0.874, 0.843–0.901 vs. 0.824, 0.801–0.853, P = 0.004).

Bottom Line: Among AFP-negative patients with very early HCC, 18 (69.2%) of 26 had positive thioredoxin results.Our results indicate that serum thioredoxin complements measurement of AFP in the diagnosis of HCC, especially in very early disease.Combined model (thioredoxin and AFP) showed a significantly greater discriminatory ability as compared with those markers alone.

View Article: PubMed Central - PubMed

Affiliation: Department of Hepatic Surgery, The Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China.

ABSTRACT
Here we found that serum levels of thioredoxin were increased in patients with hepatocellular carcinoma (HCC). The optimum diagnostic cutoff for thioredoxin was 20.5 ng/mL (area under curve [AUC] 0.946 [95% CI 0.923-0.969] in the training cohort; 0.941 [0.918-0.963] in the validation cohort). High serum concentrations of thioredoxin differentiated HCC from chronic liver diseases and cirrhosis (0.901 [0.875-0.923] in the training cohort; 0.906 [0.870-0.925] in the validation cohort). Furthermore, a higher proportion of patients with very early HCC had positive results for thioredoxin than for alpha-Fetoprotein (AFP) (73.7% VS.31.6%; P < 0.0001). Among AFP-negative patients with very early HCC, 18 (69.2%) of 26 had positive thioredoxin results. Our results indicate that serum thioredoxin complements measurement of AFP in the diagnosis of HCC, especially in very early disease. Combined model (thioredoxin and AFP) showed a significantly greater discriminatory ability as compared with those markers alone.

No MeSH data available.


Related in: MedlinePlus