Serum heat shock protein 27 levels in patients with hepatocellular carcinoma

Abstract

Levels of serum heat shock protein 27 (sHsp27) have been studied in numerous cancer types, but their potential relevance in patients with hepatocellular carcinoma (HCC) is undetermined. Our aim was to compare sHsp27 levels in patients with HCC and HCC-free controls. Specifically, we recruited 71 patients with HCC (80 % with early tumour), 80 patients with chronic liver disease (59 with liver cirrhosis and 21 with chronic active hepatitis) and 42 healthy subjects. sHsp27 was measured by immunoenzymatic assay. Results showed that sHsp27 levels were significantly (p < 0.001) higher in patients with HCC than in the other groups, particularly in those with hepatitis C virus (HCV)-related disease. In HCC patients, sHsp27 levels were not associated with prognostic risk factors, such as size/multiplicity of nodules and stage. In logistic regression analysis, performed in patients with liver disease, log-sHsp27 was associated with a significant age-adjusted 2.5-fold increased odds ratio of HCC and with a significant 4.4-fold higher odds ratio of HCC in the subgroup with HCV-related liver disease. In receiver operating characteristic curve analysis, sensitivity and specificity of the best sHsp27 cut-off value (456.5 pg/ml) for differentiating patients with HCC from those with HCC-free chronic liver disease were 70 and 73 %, respectively. In conclusion, sHsp27 levels are enhanced in patients with HCC and may represent a candidate biomarker of HCC.

Fig. 1

Box plot for serum Hsp27 values in the studied groups. The box indicates the 25th and 75th percentile of the data, and the middle line, the median. A line extends from the minimum to the maximum value, excluding outliers that are displayed as separate points. CAH, chronic active hepatitis; CIR, liver cirrhosis; HCC, hepatocellular carcinoma. p < 0.001, HCC vs others; p < 0.01, CIR vs controls

Fig. 2

ROC curves comparing Hsp27 (blue), des-gamma-carboxy prothrombin (DCP, green) and α-fetoprotein (αFP, beige) in discriminating patients with and without hepatocarcinoma (HCC). Analysis was performed in all patients with chronic liver disease with and without HCC (n = 151) (a) and in the subgroup of patients (n = 60) with compensated HCV-related liver disease (b). Panel b: p < 0.05, AUROC curve for Hsp27 vs AUROC curve for αFP