2012;5(9):874-881
www.ijcep.com /ISSN:1936-2625/IJCEP1208023
Review Article
GP73 expression and its significance in the diagnosis of
hepatocellular carcinoma: a review
Ming-Chen Ba1, Hui Long2, Yun-Qiang Tang1, Shu-Zhong Cui1
1
Department of Hepatobiliary Tumor Surgery, Cancer Hospital of Guangzhou Medical College, Guangzhou
510095, PR China; 2Department of Pharmacy, Guangzhou Dermatology Institute, Guangzhou 510095, PR China
Received August 26, 2012; Accepted September 29, 2012; Epub October 20, 2012; Published October 30, 2012
Abstract: Hepatocellular carcinoma (HCC) is one of the most common malignant tumors, and its incidence has
been increasing worldwide. Serum alpha-fetoprotein (AFP) levels and abdominal ultrasound have been widely used
for diagnosis as well as surveillance of HCC. However, the sensitivity and specificity of both AFP levels and ultrasound for HCC surveillance have some shortcomings, particularly in the early stages of the disease. Golgi protein-73
(GP73) is a type II Golgi-localized integral membrane protein that is normally expressed in epithelial cells of many
human tissues. It is essential for human survival, and might have multiple roles for GP73 in epithelial cell function
such as in the kidney and liver. However, details of its biochemical function and regulation of GP73 expression are
unknown at present. GP73 expression is upregulated in serum samples from patients with liver disease, with expression being highest in HCC. Therefore, it may be useful as a new serum marker for detection of HCC in at high-risk
population. But, this hypothesis needs to be proven in large cohorts.
Keywords: Hepatocellular carcinoma, liver disease, alpha-fetoprotein, golgi protein73, tumor marker
Introduction
Hepatocellular carcinoma (HCC) is a major
health problem, being the sixth most common
cancer with 626,000 new cases in 2002. Its
incidence continues to increase all over the
world [1]. Unfortunately, patient survival with
HCC has only been marginally improved over
the last 20 years. Between 1981 and 1998,
the 5-year survival rate only rose from 2% to
5%. The poor survival rate is mainly related to
late diagnosis of HCC, when effective therapies
are lacking. Surveillance of patients at highest
risk for developing HCC (i.e., patients with cirrhosis) is an important strategy that can potentially decrease the HCC related mortality rate
[2]. Although HCC meets the criteria of a tumor
that would benefit from a surveillance program,
the poor sensitivity and specificity of currently
available tools has prevented widespread
implementation of HCC surveillance.
Alpha-fetoprotein (AFP) is a serum marker that
is most widely used for diagnosis as well as surveillance of HCC. However, AFP levels may be
normal in up to 40% of patients with HCC, particularly during the early stages of HCC.
Furthermore, elevated AFP levels may be seen
in patients with cirrhosis or exacerbations of
chronic hepatitis. Prospective studies evaluating the performance characteristics of AFP for
HCC surveillance reported sensitivities of 39%
to 64%, specificities of 76% to 91%, and positive predictive values of 9% to 32% [3-5].
Abdominal ultrasound is the most common
imaging modality used for surveillance of HCC,
and it can lead to increased survival of patients
with cirrhosis who develop HCC by allowing earlier implementation of disease management
strategies. The sensitivity, specificity, and positive predictive value of ultrasound for HCC have
been reported to be 71% to 78%, 90% to 93%,
and 14% to 73%, respectively [6]. However, the
accuracy of ultrasound can be limited by the
ability of the operator to differentiate HCC from
non-neoplastic lesions such as regenerative
nodules [7]. Development of more sensitive
and specific serum biomarkers for the early
detection of HCC in the at-risk population may
lead to improved survival of patients. Given
875
876
877
AFP-negative (%)
Marrero et al 2005
Mao et al 2008
Wang et al 2009
Hu et al 2010
62% (32/52)
35.1%(12/37)
49.1% (61/124)
AUROC
0.79
0.94
0.89
GP73
Sensitivity
69%
76.9%
95 %
77.4%
specificity
86%
92.9%
70 %
83.9%
AUROC
0.61
0.83
0.77
AFP
Sensitivity
30%
48.6%
95%
48.4%
specificity
96%
75%
28%
96.8%
GP73, Golgi protein-73; AFP, Alpha-fetoprotein; AUROC, area under the receiver operating curve.
879
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