Background: Hepatocellular carcinoma (HCC) is the fourth most common cause of cancer-related deaths globally. Long non-coding RNAs (lncRNAs) may be considered as potential markers for HCC. The aim of this study is to evaluate the diagnostic and prognostic value of lncRNA ZFAS1 in HCC patients.
Materials and methods: The current study included 100 cirrhotic patients with HCC, in addition to 100 cirrhotic patients without HCC as control group. RNA extraction was performed for quantification of ZFAS1 expression by real-time quantitative polymerase chain reaction.
Results: ZFAS1 gene expression was significantly elevated in HCC group of patients compared to non-HCC group. The ability to distinguish HCC from cirrhotic controls by ZFAS1 was determined to be 1.00 (95% CI:1.00-1.00). Comparison between the diagnostic performance of ZFAS1 and AFP in differentiating HCC on top of cirrhosis from cirrhosis without HCC showed that, at cutoff values ≥ -4.65  ZFAS1 gene had 100 % specificity and 99% sensitivity while, AFP at cutoff value ≥ 9.4 ng/ml had 100 % specificity and 76% sensitivity. Comparison of AUC for the two parameters demonstrated a significantly higher AUC for ZFAS1 than for AFP (Difference = 0.168, P <0.001). No statistically significant correlation between ZFAS1gene and any HCC characteristic however, a statistically significant correlation between AFP level and sex , BCLC staging was found.
Conclusions: lncRNA ZFAS1 is a good diagnostic marker for HCC in cirrhotic patients with high sensitivity and specificity value, however ZFAS1has no prognostic importance in patients with HCC.s