Evaluation of Serum Clusterin as a Promising Marker for Diagnosis and Staging of Hepatocellular Carcinoma

The prevalence of Hepatocellular carcinoma (HCC) in Egypt is extensively increasing. Clusterin has been reported to play a significant role in cancer development and progression through promoting cell survival. We aimed to evaluate CLU as a recent marker for HCC and its correlation with HCC stage in patients with chronic hepatitis C infection (HCV). The study included 15 patients with uncomplicated chronic HCV infection, 15 patients with decompensated liver cirrhosis and 40 patients with HCC on top of liver cirrhosis (furtherly subdivided according to TNM classification). Serum alpha fetoprotein and serum clustrin level were measured for all patients. Our results showed that CLU significantly decrease with decompensated liver cirrhosis compared to uncomplicated chronic hepatitis. CLU rise significantly in patients with HCC. CLU level of 182 µg/ml is a discriminating level between HCC TNM stage I (non metastatic) and TNM stage II and III (metastatic). At this level the diagnostic sensitivity is 70%, specificity 80%. The accuracy can be improved when linked to AFP at cut off value 273 ng/ml. Conclusion: CLU may be a useful marker for follow up of patients with chronic hepatitis C for diagnosis of hepatic decompensation and HCC. CLU level may be used in staging of HCC and can be a target of new therapy to prevent tumor progression.