Background and study aim: Hepatocellular carcinoma (HCC) is the most common primary liver ‎cancer, coming 4th in most common cancers, and 2nd in cancer-related ‎mortality in Egypt. HCC biomarkers help in case screening, diagnosis, ‎and follow-up. This study aims at evaluating the diagnostic value of ‎plasma osteopontin (OPN) compared to alpha-fetoprotein (AFP) for ‎diagnosing HCC in Egyptian patients.
Patients and Methods: ‎‎‎ 120 ‎subjects in Alrajhi Liver Hospital, Assiut University were included (60 ‎HCC, 30 liver cirrhosis, and 30 healthy individuals). Plasma OPN and ‎AFP levels were evaluated using commercially available ELISA kits. ‎Uncontrolled diabetic and hypertensive patients, patients with other ‎tumors than HCC or those receiving HCC treatments were excluded‎‎‎‎‎‎.‎.‎
Results: OPN plasma levels were higher in HCC group compared to cirrhotic ‎and control groups respectively (200 vs. 77.5 vs. 25.5 ng/ml, p < 0.05). ‎Tumors >5cm in diameter resulted in significantly higher plasma OPN ‎compared to tumors ‎or lymph nodes didn't significantly affect OPN levels in HCC group ‎‎(p>0.05). Diagnostic sensitivity, specificity, and overall accuracy of ‎OPN for HCC vs Cirrhotic group were superior to AFP (97%, 70%, ‎and 84% at cut-off value 90 ng/mL for OPN vs 90%, 63% and 77% at ‎cut-off value 5.5 ng/ml for AFP). The area under the ROC curve (AUC) ‎value for OPN was higher than AUC value for AFP (0.923 vs. 0.902)‎‎‎‎‎‎.
Conclusion: Serum OPN had better diagnostic ability for detecting HCC compared to ‎AFP, suggesting OPN as a promising diagnostic marker for HCC at ‎normal AFP levels‎‎‎‎.