Clin Mol Hepatol.  2016 Sep;22(3):359-365. 10.3350/cmh.2016.0033.

Glypican-3 level assessed by the enzyme-linked immunosorbent assay is inferior to alpha-fetoprotein level for hepatocellular carcinoma diagnosis

• Jeon Y
• Jang ES
• Choi YS
• Kim JW
• Jeong SH

• KMID: 2373136
• DOI: http://doi.org/10.3350/cmh.2016.0033

Abstract

BACKGROUND/AIMS
Glypican-3 (GPC3) protein is highly expressed in hepatocellular carcinoma (HCC) tissue. It has been suggested as a diagnostic biomarker, but its inconsistent performance means that it requires further assessment. We therefore investigated the diagnostic value of the plasma GPC3 level compared to the alpha-fetoprotein (AFP) level as a diagnostic biomarker of HCC.
METHODS
We enrolled 157 consecutive patients with newly diagnosed HCC and 156 patients with liver cirrhosis (LC) as the control group. GPC3 plasma levels were measured using two commercially available enzyme-linked immunosorbent assays (ELISAs, named as Assay 1 and 2), and AFP levels were measured using an enzyme-linked chemiluminescent immunoassay. The diagnostic accuracy was analyzed using the receiver operating characteristics (ROC) curve.
RESULTS
Plasma GPC3 levels in HCC patients were very low (0-3.09 ng/mL) in Assay 1, while only 3 of the 157 patients (1.9%) showed detectable GPC3 levels in Assay 2. The median GPC3 level was not significantly elevated in the HCC group (0.80 ng/mL) compared with the LC group (0.60 ng/mL). The area under the ROC curve (AUC) for GPC3 was 0.559 in Assay 1. In contrast, the median AFP level was significantly higher in HCC (27.72 ng/mL) than in LC (4.74 ng/mL), with an AUC of 0.729.
CONCLUSION
The plasma level of GPC3 is a poor diagnostic marker for HCC, being far inferior to AFP. The development of a consistent detection system for the blood level of GPC3 is warranted.

Keyword

Alpha-fetoprotein; Biomarkers; Diagnosis; Glypican-3; Hepatocellular carcinoma; Sensitivity, Specificity

MeSH Terms

Aged
Aged, 80 and over
Area Under Curve
Biomarkers, Tumor/blood
Carcinoma, Hepatocellular/*diagnosis/pathology
Enzyme-Linked Immunosorbent Assay
Female
Glypicans/*blood
Humans
Liver Neoplasms/*diagnosis/pathology
Male
Neoplasm Staging
ROC Curve
alpha-Fetoproteins/*analysis
Biomarkers, Tumor
Glypicans
alpha-Fetoproteins