الفهرس 
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Abstract
HCC is among the most prevalent tumors that are malignant. HCC is typically identified late, leading to a dismal diagnosis and a five-year survival rate of less than 5%. (Chidambaranathan-Reghupaty et al., 2021). Accurate identification and differential diagnosis of early HCC can dramatically increase the survival of patients. In medical care, HCC is detected by diagnostic imaging methods and blood indicators such as α-AFP, fucosylated AFP, and des-γ-carboxyprothrombin. Still, these approaches have limited sensitivity and specificity, particularly in the beginning stages of HCC. In recent years, high-throughput technologies have clarified several additional processes related to hepatocarcinogenesis, resulting in the identification of numerous novel, non-invasive blood biomarkers. Specifically, the combination of AFP (Reichl & Mikulits, 2016; Tang et al., 2017).
Early detection of HCC and appropriate therapy aid to extend the lifespan of hepatic cancer patients (Trinchet et al., 2009) Macrophages, osteoblasts, and T cells release osteopontin (OPN), which is a phosphorylated glycoprotein. The OPN gene is found on chromosome 4 region 22 (4q22.1) (Si et al., 2020). OPN production has been discovered in a variety of tissues and associated with several clinical diseases, involving inflammatory processes, angiogenesis, fibrosis, and cancer (Wen et al., 2016).
In the recent study, our goal is the investigation of OPN level in HCC patients with or without HCV for diagnosis HCC. Osteopontin is a useful tumor marker because it exists as both an adsorbed extracellular matrix molecule and a released from body fluids such as plasma. OPN concentrations in the plasma were discovered to be considerably greater in patients with HCC than in normal controls persons and greater than in patients with chronic liver disorders (Z.-S. Huang, Wang, & Wu, 2010)
Biochemical laboratory evaluation (AST, ALT, albumin and ALP) was indicated using instruction of each method. All evaluated biochemical markers extremely statistically significantly different among AST, ALT, ALB, and ALP level in patients with HCC patients (G3-G4) and non-significant HCC (G1-G2).
All samples in each group were examined for OPN, AFP, CEA and AFP by ELISA method in accordance with instructions, on the other hand The serum proteins were separated by SDS-PAGE then transformed to nitrocellulose sheet to detect molecular weight of Osteopontin
In our study, OPN was identified in serum samples of HCC patients through polyclonal antibody (poAb) special for OPN. The molecular weight of the sharp band of OPN was at 68 kDa in patients using standard proteins mixture
In the present research, the level of OPN was measured using ELISA for 140 patients (71 with significant HCC patients and 59 non-significant HCC patients). OPN was detected in 71 (88.75 %) out of 80 patients with significant HCC, 9(11.25 %) were negative for OPN (false negative). About 59 (98%) out of 60 patients with non-significant HCC, were negative for OPN and 1 (2%) out of non-significant HCC patients were positive OPN (false positive). On the other hand, the diagnostic performance of serum OPN was determined.
using OPN cut-off =197 ng/mL, NPV and PPV for HCC diagnosis of were 87.76%, 98.6% respectively. We investigated the diagnostic accuracy of OPN (ng/mL) for diagnosis of HCC patients by ROC Curve. By ROC analysis, we found that AUROC of OPN for discriminating significant HCC from non-significant HCC and P value were 0.913 and P < 0.0001; accordingly.
on the cut-off level 197 ng/ml, OPN marker showed higher degrees of sensitivity, specificity and efficiency (88.7%, 98.3%, and 92.8%; respectively) for diagnosis of HCC patients.
OPN showed significantly higher degrees of AUROC than the other three biomarkers (CEA, CA19-9 and AFP) assays. OPN showed significantly (p < 0.05) higher degrees of sensitivity, specificity and efficiency than the other three biomarkers (CEA, CA19-9 and AFP) assays.