Serum levels of clusterin were measured by a sandwich enzyme-linked immunosorbent assay. Results:  The serum clusterin levels in HCC patients were significantly lower than that in healthy, HBV carriers and chronic hepatitis B, but statistically higher than in cirrhosis patients. Receiver operator characteristic (ROC) curve indicated that a serum clusterin value of 50 µg/mL yielded the best sensitivity (91%) and specificity (83%) for differentiating

HCC patients with HBV-related cirrhosis from those with HBV-related cirrhosis. The optimal alpha fetoprotein Selleckchem ABT 199 (AFP) cutoff value was 15 ng/mL and was inferior to the clusterin value of 50 µg/mL, the area under the ROC curves being 0.937 versus 0.781, respectively (P < 0.05). Conclusions:  Serum clusterin was more sensitive and specific than serum AFP for differentiating HCC patients with HBV-related

cirrhosis from those with HBV-related liver cirrhosis, and may be a useful surveillance tool of HCC based on HBV-related cirrhosis. Hepatocellular carcinoma (HCC) is the fourth most frequent cancer worldwide, and causes almost 250 000 deaths annually.1,2 However, patient survival in HCC has not improved find more significantly over the last two decades, and the 5-year survival rate only rose from 2% to 5%.3 To date, the pathogenesis of HCC is still not clear. It is known, that hepatitis B virus (HBV) infection and liver cirrhosis 上海皓元医药股份有限公司 are high risk factors and may progress to HCC. HCC is often diagnosed at an advanced stage where effective therapies are lacking, so the surveillance of patients

at risk is necessary. Currently, standard surveillance includes a combination of 6-monthly abdominal ultrasound scans (US) and serum alpha fetoprotein (AFP) measurement.4,5 However, AFP is not a very good screening test, since it has a sensitivity of 39–64%, a specificity of 76–91% and a positive predictive value of 9–32%.5–7 As a screening test in HBsAg carriers, US has a sensitivity of 71% and specificity of 93%, but its positive predictive value is only 14%.6 Therefore, there is a need for developing simple and reliable serum markers that will improve the detection rate of early HCC. Clusterin is a secretory heterodimeric glycoprotein (75–80 kDa) expressed in several tissues and present in all human fluids.8–13 It has been involved in a wide range of physiological and pathophysiological processes important for carcinogenesis and tumor growth, including lipid transportation and redistribution, apoptosis, cell cycle regulation, DNA repair, folding of damaged extracellular proteins (chaperone), cell adhesion and aggregation, membrane recycling, complement regulation, tissue remodeling, tumorigenesis and immune system regulation.11–15 In many diseases including human cancers, the expression status of clusterin might change at mRNA and protein levels.