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Abdel Ghafar MT, Elkhouly RA, Elnaggar MH, et al. Utility of serum neuropilin-1 and angiopoietin-2 as markers of hepatocellular carcinoma. J Investig Med. 2021;69(6):1222-1229doi: 10.1136/jim-2020-001744.
Abdel Ghafar, M. T., Elkhouly, R. A., Elnaggar, M. H., Mabrouk, M. M., Darwish, S. A., Younis, R. L., & Elkholy, R. A. (2021). Utility of serum neuropilin-1 and angiopoietin-2 as markers of hepatocellular carcinoma. Journal of investigative medicine : the official publication of the American Federation for Clinical Research, 69(6), 1222-1229. https://doi.org/10.1136/jim-2020-001744
Abdel Ghafar, Muhammad Tarek, et al. "Utility of serum neuropilin-1 and angiopoietin-2 as markers of hepatocellular carcinoma." Journal of investigative medicine : the official publication of the American Federation for Clinical Research vol. 69,6 (2021): 1222-1229. doi: https://doi.org/10.1136/jim-2020-001744
Abdel Ghafar MT, Elkhouly RA, Elnaggar MH, Mabrouk MM, Darwish SA, Younis RL, Elkholy RA. Utility of serum neuropilin-1 and angiopoietin-2 as markers of hepatocellular carcinoma. J Investig Med. 2021 Aug;69(6):1222-1229. doi: 10.1136/jim-2020-001744. Epub 2021 Apr 08. PMID: 33833047.
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J Investig Med. 2021 Aug;69(6):1222-1229. doi: 10.1136/jim-2020-001744. Epub 2021 Apr 08.

Utility of serum neuropilin-1 and angiopoietin-2 as markers of hepatocellular carcinoma.

Journal of investigative medicine : the official publication of the American Federation for Clinical Research

Muhammad Tarek Abdel Ghafar, Reham A Elkhouly, Mohammed H Elnaggar, Mohamed M Mabrouk, Sara A Darwish, Reham L Younis, Rasha A Elkholy

Affiliations

  1. Clinical Pathology, Tanta University Faculty of Medicine, Tanta, Egypt [email protected].
  2. Tropical Medicine, Tanta University Faculty of Medicine, Tanta, Egypt.
  3. Internal Medicine, Tanta University Faculty of Medicine, Tanta, Egypt.
  4. Clinical Oncology and Nuclear Medicine, Tanta University Faculty of Medicine, Tanta, Egypt.
  5. Physiology, Tanta University Faculty of Medicine, Tanta, Egypt.
  6. Clinical Pathology, Tanta University Faculty of Medicine, Tanta, Egypt.

PMID: 33833047 DOI: 10.1136/jim-2020-001744

Abstract

This study aimed to assess the diagnostic value of two serum angiogenetic markers neuropilin-1 (NRP-1) and angiopoietin-2 (ANG-2) in patients with hepatocellular carcinoma (HCC) and their relation to tumor characteristics. 149 subjects were recruited and divided into 50 patients with recently diagnosed HCC, 49 patients with cirrhosis on top of hepatitis C virus infection, and 50 healthy subjects. Serum NRP-1 and ANG-2 were estimated by ELISA. Alpha-fetoprotein (AFP) levels were measured using fluorescence immunoassay. Serum NRP-1 and ANG-2 levels were significantly higher in patients with HCC (2221.8±1056.6 pg/mL and 3018.5±841.4 pg/mL) than healthy subjects (219.3±61.8 pg/mL and 2007.7±904.8 pg/mL) and patients with cirrhosis (1108.9±526.6 pg/mL and 2179.1±599.2 pg/mL), respectively. In multivariate logistic regression analysis, NRP-1 and AFP were the only independent factors of HCC development and correlated positively with each other (r=0.781, p<0.001). Receiver operating characteristic curve analysis showed that the area under the curve (AUC) of NRP-1 was higher than that of ANG-2 in discriminating HCC from patients with cirrhosis (0.801 vs 0.748, p=0.250) and healthy subjects (0.992 vs 0.809, p<0.001). The AUC of NRP-1 was detected to be increased (0.994) when combined estimation with AFP was performed. Elevated serum NRP-1 and ANG-2 levels were detected in patients with HCC with tumor numbers >3, tumor size ≥5 cm, tumor stages B/C according to the Barcelona Clinic Liver Cancer staging system, vascular invasion, and distant metastasis. In conclusion, NRP-1 is a potential serological marker for HCC diagnosis and is better than ANG-2. It is feasible to be estimated in combination with AFP to enhance its diagnostic power. High serum NRP-1 and ANG-2 levels are associated with advanced HCC tumor characteristics.

© American Federation for Medical Research 2021. No commercial re-use. See rights and permissions. Published by BMJ.

Keywords: alpha-fetoproteins; angiopoietins; carcinoma; diagnostic tests; hepatocellular; liver cirrhosis; routine

Conflict of interest statement

Competing interests: None declared.

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