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Research Article
Serum Epidermal Growth Factor-like domain 7 Serves as a Novel Diagnostic Marker for Early Hepatocellular Carcinoma
Lian-Yue Yang
Liver Cancer Laboratory, Xiangya Hospital, Central South University
Corresponding Author
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Background: Epidermal growth factor-like domain 7 (Egfl7), a recently identified secreted protein, was significantly increased in patients with HCC by our previous studies. However, its efficacy in diagnosis of early HCC remains unknown. In this study we evaluate the efficacy of serum Egfl7 for early HCC diagnosis and compare it with alpha-fetoprotein (AFP).
Methods: Serum Egfl7 levels in testing cohort (1065 participants) and validation cohort (464 participants) were measured by a sandwich enzyme-linked immunoassay (ELISA). The efficacies of Egfl7 and AFP in diagnosing early HCC were estimated by receiver operating characteristic (ROC).
Results: Serum Egfl7 was significantly elevated in patients with early HCC than all non-HCC controls. At the cut-off value of 2610 ng/mL, the area under ROC, sensitivity, specificity and accuracy of Egfl7 were 0.800, 75.2 %, 71.7% and 73.5% in discriminating early HCC from chronic liver disease (CLD), compared with 0.675, 61.8%, 62.0% and 61.9% for AFP using 20 ng/mL as a cut-off value. Egfl7 also exhibited a significant higher sensitivity and accuracy than AFP in differentiating early HCC patients from non-HCC individuals including healthy individuals and patients with CLD (76.6% vs. 64.0%, 79.9% vs. 66.1%). Additionally, 70.8% of early HCC patients with negative AFP could be diagnosed by Egfl7 and the combined use of Egfl7 and AFP increased the sensitivity to 91.0%. These results were confirmed by a validation cohort.
Conclusion: Egfl7 is a valuable serum marker in early diagnosis of HCC with a better sensitivity and accuracy than AFP.
Keywords
Hepatocellular carcinoma, Eepidermal growth factor-like domain 7, Alpha-fetoprotein, Early diagnosis, Serum marker
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This preprint is under consideration at BMC Cancer. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research Article
Serum Epidermal Growth Factor-like domain 7 Serves as a Novel Diagnostic Marker for Early Hepatocellular Carcinoma
Lian-Yue Yang
Liver Cancer Laboratory, Xiangya Hospital, Central South University
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 28 Dec, 2020
No community comments so far
Review #7 received
Received 08 Jan, 2021
Review #1 received
Received 08 Jan, 2021
Review #5 received
Received 08 Jan, 2021
Review #3 received
Received 08 Jan, 2021
Review #6 received
Received 08 Jan, 2021
Reviewer #3 agreed
On 26 Dec, 2020
Reviewer #9 agreed
On 26 Dec, 2020
Reviewer #7 agreed
On 24 Dec, 2020
Reviewer #4 agreed
On 24 Dec, 2020
Reviewer #2 agreed
On 24 Dec, 2020
Reviewer #5 agreed
On 24 Dec, 2020
Reviewer #14 agreed
On 24 Dec, 2020
Reviewer #6 agreed
On 24 Dec, 2020
Reviewer #8 agreed
On 24 Dec, 2020
Reviewer #1 agreed
On 24 Dec, 2020
Reviewer #12 agreed
On 24 Dec, 2020
Reviewer #10 agreed
On 24 Dec, 2020
Reviewer #13 agreed
On 24 Dec, 2020
Reviewers invited
Invitations sent on 23 Dec, 2020
Editor assigned
On 23 Dec, 2020
Editor invited
On 23 Dec, 2020
Submission checks complete
On 23 Dec, 2020
First submitted
On 14 Dec, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Cancer Biology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Epidermal growth factor-like domain 7 (Egfl7), a recently identified secreted protein, was significantly increased in patients with HCC by our previous studies. However, its efficacy in diagnosis of early HCC remains unknown. In this study we evaluate the efficacy of serum Egfl7 for early HCC diagnosis and compare it with alpha-fetoprotein (AFP).
Methods: Serum Egfl7 levels in testing cohort (1065 participants) and validation cohort (464 participants) were measured by a sandwich enzyme-linked immunoassay (ELISA). The efficacies of Egfl7 and AFP in diagnosing early HCC were estimated by receiver operating characteristic (ROC).
Results: Serum Egfl7 was significantly elevated in patients with early HCC than all non-HCC controls. At the cut-off value of 2610 ng/mL, the area under ROC, sensitivity, specificity and accuracy of Egfl7 were 0.800, 75.2 %, 71.7% and 73.5% in discriminating early HCC from chronic liver disease (CLD), compared with 0.675, 61.8%, 62.0% and 61.9% for AFP using 20 ng/mL as a cut-off value. Egfl7 also exhibited a significant higher sensitivity and accuracy than AFP in differentiating early HCC patients from non-HCC individuals including healthy individuals and patients with CLD (76.6% vs. 64.0%, 79.9% vs. 66.1%). Additionally, 70.8% of early HCC patients with negative AFP could be diagnosed by Egfl7 and the combined use of Egfl7 and AFP increased the sensitivity to 91.0%. These results were confirmed by a validation cohort.
Conclusion: Egfl7 is a valuable serum marker in early diagnosis of HCC with a better sensitivity and accuracy than AFP.
Figure 1
Figure 2
Figure 3
Figure 4