Potential role of pentraxin 3 (PTX3) and aldehyde dehydrogenase (ALDH) in liver cirrhotic patients: predicting and diagnostic impact in hepatocellular carcinoma (HCC) development

Abstract

Background and objective: Patients with liver cirrhosis (LC) are at the highest risk of developing hepatocellular carcinoma (HCC). Thus, this research aimed to clarify the tumorigenic potential of PTX3 and ALDH implicated in HCC development and to find a novel diagnostic model for predicting HCC earlier in liver cirrhotic Egyptian patients.

Patients and methods: 88 patients hospitalized at Gastrointestinal Surgery Center for liver transplantation; 63 HCV-chronic liver disease patients after successful Direct acting antiviral (DAA) therapy (30 HCC patients on top of LC and 33 LC patients) and 25 Non-viral LC in addition to 25 healthy individuals. PTX3 and ALDH serum levels were estimated by Enzyme linked immunosorbent assay (ELISA).

Results: PTX3, ALDH and AFP were significantly correlated with each other and its higher expression was associated with tumor differentiation and inflammatory markers in HCC patients and with LC activity in HCV-LC. Regression analysis of PTX3, ALDH, AFP and the inflammatory markers (PLR, NLR, AAR, Pt) evidenced substantial prediction for tumor grading, Child score, and LC activity as independent predictors for disease severity and tumor progression. Composite score of PTX3 + AFP + FIB4 exhibit higher diagnostic accuracy for discriminating HCC from LC patients with AUROC (0.872), sensitivity (90%), specificity (87.8%) and Accuracy (88.9%).

Conclusions: Inflammation and tissue injury might provoke the tumorigenic potential of PTX3 and ALDH in HCV chronic liver diseases foremost HCC development even after successful eradication for HCV. Diagnostic model (PTX3 + AFP + FIB4) showed the best diagnostic accuracy for discriminating HCC from LC patients.

Keywords: ALDH; HCC; HCV-chronic liver diseases; LC; Pentraxin-3.