Osteopontin and Human Aldehyde Dehydrogenase (ALDH) as a Tumor Marker for Detection of Hepatocellular Carcinoma

Background/Aim: Hepatocellular carcinoma (HCC) is a global health problem because of its increasing prevalence worldwide and its poor prognosis. In Egypt HCC incidence has increased sharply and nearly doubled over the last decade. The outcome of HCC depends mainly on its early diagnosis; therefore, new and specific markers for HCC are critically needed. Osteopontin (OPN) is a glycoprotein that over expressed in HCC and known to be an independent predictor of poor prognosis. Aldehyde dehydrogenase (ALDH) is a polymorphic enzyme responsible for the oxidation of aldehydes to carboxylic acids, which leave the liver and are metabolized by the body’s muscle and heart. ALDH1 and ALDH2 are the most important enzymes for aldehyde oxidation. These enzymes are found in many tissues of the body but are at the highest concentration in the liver. The aim was to assess the value of OPN in Egyptian patients with HCC.

Methods: This study included 50 patients with HCC, 50 patients with liver cirrhosis and 50 healthy controls. For all groups, clinical data and image findings were studied; serum alpha-fetoprotein & ALHD & OPN levels were detected by enzyme immunoassay (EIA) kit. Tumor characteristics were assessed including size, number and site.

Results: Our data showed that ALDH was more sensitive and specific than AFP, ALDH had 74% sensitivity and 82% specificity, P- value (0.000) but AFP had 66% sensitivity and 64% specificity, P-value (0.003). However, serum OPN was significantly higher in HCC patients compared to cirrhotic patients and controls. The sensitivity and specificity in diagnosis of HCC were 92.5% and 85% respectively at cutoff of 239 ng/ml with 91.1% accuracy.

Conclusion: OPN could be a useful diagnostic & prognostic marker for detection of HCC more than ALDH or AFP.

Keywords: Hepatocellular carcinoma, ALDH, Osteopontin, Alpha-fetoprotein.