Identification of serum monocyte chemoattractant protein-1 and prolactin as potential tumor markers in hepatocellular carcinoma

PLoS One. 2013 Jul 18;8(7):e68904. doi: 10.1371/journal.pone.0068904. Print 2013.

Abstract

Early diagnosis of hepatocellullar carcinoma (HCC) remains a challenge. The current practice of serum alpha-fetoprotein (AFP) measurement is inadequate. Here we utilized a proteomic approach to identify novel serum biomarkers for distinguishing HCC patients from non-cancer controls. We profiled the serum proteins in a group of 58 resectable HCC patients and 11 non-HCC chronic hepatitis B (HBV) carrier samples from the Singapore General Hospital (SGH) using the RayBio® L-Series 507 Antibody Array and found 113 serum markers that were significantly modulated between HCC and control groups. Selected potential biomarkers from this list were quantified using a multiplex sandwich enzyme-linked immunosorbent assay (ELISA) array in an expanded SGH cohort (126 resectable HCC patients and 115 non-HCC chronic HBV carriers (NC group)), confirming that serum prolactin and monocyte chemoattractant protein-1 (MCP-1) were significantly upregulated in HCC patients. This finding of serum MCP-1 elevation in HCC patients was validated in a separate cohort of serum samples from the Mochtar Riady Institute for Nanotechnology, Indonesia (98 resectable HCC, 101 chronic hepatitis B patients and 100 asymptomatic HBV/HCV carriers) by sandwich ELISA. MCP-1 and prolactin levels were found to correlate with AFP, while MCP-1 also correlated with disease stage. Subsequent receiver operating characteristic (ROC) analysis of AFP, prolactin and MCP-1 in the SGH cohort and comparing their area under the ROC curve (AUC) indicated that neither prolactin nor MCP-1 on their own performed better than AFP. However, the combination of AFP+MCP-1 (AUC, 0.974) had significantly superior discriminative ability than AFP alone (AUC, 0.942; p<0.001). In conclusion, prolactin and MCP-1 are overexpressed in HCC and are conveniently quantifiable in patients' sera by ELISA. MCP-1 appears to be a promising complementary biomarker for HCC diagnosis and this MCP-1+AFP model should be further evaluated as potential biomarker on a larger scale in patients at-risk of HCC.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Biomarkers, Tumor / blood*
  • Carcinoma, Hepatocellular / blood
  • Carcinoma, Hepatocellular / diagnosis*
  • Chemokine CCL2 / blood*
  • Cohort Studies
  • Enzyme-Linked Immunosorbent Assay
  • Humans
  • Indonesien
  • Liver Neoplasms / blood
  • Liver Neoplasms / diagnosis*
  • Prolactin / blood*
  • Proteomics
  • ROC Curve
  • Singapur

Substances

  • Biomarkers, Tumor
  • Chemokine CCL2
  • Prolactin

Grants and funding

Study of the SGH cohort in this research was supported by grants awarded by the National Medical Research Council (NMRC), Ministry of Health, Republic of Singapore (NMRC/1191/2008 and NMRC/IBG/NCC/2009; http://www.nmrc.gov.sg/content/nmrc_internet/home.html). Study of the MRIN cohort was supported by the institutional funding of MRIN (http://www.mrinstitute.org/). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.