Published online Aug 18, 2017. doi: 10.4254/wjh.v9.i23.1001
Peer-review started: February 17, 2017
First decision: April 20, 2017
Revised: May 31, 2017
Accepted: June 19, 2017
Article in press: June 20, 2017
Published online: August 18, 2017
Processing time: 184 Days and 14.2 Hours
To assess the role of some circulating miRNAs (miR-23a, miR-203, miR338, miR-34, and miR-16) as tumor markers for diagnosis of hepatocellular carcinoma (HCC).
One hundred and seventy-one subjects were enrolled, 57 patients with HCC, 57 patients with liver cirrhosis (LC) and 57 healthy subjects as control group. Severity of liver disease was assessed by Child Pugh score. Tumor staging was done using Okuda staging system. Quantification of Micro RNA (miR-23a, miR-203, miR338, miR-34, and miR-16) was performed.
All studied miRNA showed significant difference between HCC and cirrhotic patients in comparison to healthy control. miR-23a showed statistically significant difference between HCC and cirrhotic patients being higher in HCC group than cirrhotic. miR-23a is significantly higher in HCC patients with focal lesion size equal or more than 5 cm, patients with multiple focal lesions and Okuda stage III. At cutoff value ≥ 210, miR-23a showed accuracy 79.3% to diagnose HCC patients with sensitivity 89.47% and specificity about 64.91%. At cut off level ≥ 200 ng/mL, serum alpha fetoprotein had 73.68% sensitivity, 52.63% specificity, 43.75% PPV, 80% NPV for diagnosis of HCC.
MicroRNA 23a can be used as a screening test for early detection of HCC. Also, it is related to larger size of tumour, late Okuda staging and multiple hepatic focal lesions, so it might be a prognostic biomarker.
Core tip: MicroRNA is promising as diagnostic and prognostic biomarkers. miR-23a can be used in screening of hepatocellular carcinoma (HCC) and it gives better results than alpha fetoprotein. It is also related to more progressive HCC so it can be used as predictor of prognosis.