Changes Of Postoperative Serum Egf17 And Its Role In Monitoring The Recurrence And Metastasis Of Patients With HCC After Hepatic Resection

Backgrounds: Hepatocellular carcinoma (HCC) is one of the most common malignancies, the annual new cases of HCC in the globe reached 711,000, of which more than half occurred in China. Because of the high rates of incidence, recurrence and mortality, HCC has already threatened the lives of our country and the world. Although researchers have made a great effort in the study of monitoring the postoperative recurrence and metastasis of patients with HCC, important progress hasn't been found. So screening for the markers that can warn HCC recurrence and metastasis is a key program in HCC research now, the diagnosis of serum markers plays an important role in improving the level of treatment. Recently, several studies found that Egfl7 (epidermal growth factor-like domain 7) is a secreted protein which may take part in the key step of the tumor invasion and metastasis. The studies in the tumor tissue and tumor cell lines all found that Egfl7 is t shown to be highly expressed. Furthermore, our previous researches have showed that Egfl7 protein mainly locates in the cytoplasm of tumor cells and its levels are associated with the clinicopathological parameters and recurrence /metastasis of HCC. According to the evidence above, we speculate Egfl7 may be associated with the postoperative recurrence and metastasis of patients with hepatocellular carcinoma. However, the changes of postoperative serum Egfl7 and its role in monitoring the recurrence and metastasis of patients with HCC after hepatic resection remain unknown. Objectives: To investigate the changes of postoperative serum Egfl7. To compare the value between the role of Egfl7 serum levels and AFP in monitoring the postoperative recurrence and metastasis of patients with HCC. To evaluate the clinical value of postoperative serum Egfl7 in monitoring the recurrence and metastasis of patients with HCC after hepatic resection.Methods: The levels of Egfl7 in serum specimens of 25 cases HCC preoperative-postoperative-recurrence and metastasis group patients and 14 cases control group patients at different time points were detected by double-antibody sandwich ELISA, the time of collecting serum specimens are the fourth, the seventh and the tenth day after operation. We investigated the changes of the Egfl7 levels. The levels of AFP in the patients at different time points were detected by C-12 multiple tumor marker protein chip at the same time. We compared the value between the role of Egfl7 serum levels and AFP in monitoring the postoperative recurrence and metastasis of patients with HCC. We also analyzed the levels of serum Egfl7 and AFP in HCC patients who underwent hepatectomy, to evaluate the clinical value of postoperative serum Egfl7 in monitoring the recurrence and metastasis of patients with HCC after hepatic resection.Results: The levels of Egfl7 in HCC patients gradually dropped, and the levels of Egfl7 on the tenth postoperative day were the lowest. Once the recurrence and metastasis occurrencing, the levels of Egfl7 rose and were significantly higher than that on the tenth postoperative day (4201.85 ng/ml vs 1748.64 ng/ml, P<0.05) . But there was no significant changes in control group, and the levels of Egfl7 in HCC preoperative- postoperative-recurrence and metastasis group were higher than that in control group. The levels of Egfl7 in HCC preoperative- postoperative -recurrence and metastasis group on the tenth postoperative day were lower than the Cutoff value. Once the recurrence and metastasis occurrencing, the levels were significantly higher than the Cutoff value. But the expression levels of AFP on the tenth postoperative day didn't drop to the normal level. The results independently support the high sensitivity and the great potentiality of serum Egfl7 as a biomarker for monitoring the postoperative recurrence and metastasis of patients with HCC.ROC analysis displayed 92.0 % sensitivity and 69.6 % specificity which were calculated for the combined analysis of Egfl7 and AFP serum levels in HCC patients with postoperative recurrence and metastasis versus without postoperative recurrence and metastasis (AUC 0.901). Furthermore, 81.8% (9 of 11) HCC patients with negative AFP could be detected as Egfl7 positive.Conclusions: Monitoring the dynamic changes of postoperative serum Egfl7 has great significant in the diagnosis of postoperative recurrence and metastasis of patients with HCC. Egfl7 could serve as a novel serological marker which could monitor the postoperative recurrence and metastasis of patients with HCC.