The Value of Thioredoxin Level and its Gene Polymorphism in the Diagnosis of Post- HCV Hepatocellular Carcinoma

Background: Hepatocellular carcinoma (HCC) is one of the most common malignancies and a leading cause of cancer-related death worldwide. Indeed, we need a novel tumor marker other than AFP for early detection and to improve the outcome. Serum thioredoxin is a promising protein involved in the pathogenesis of many malignancies. The study aims to evaluate serum thioredoxin and its gene polymorphism in HCC in cirrhotic patients due to HCV infection. Patients and Methods: 350 patients with HCC, 350 patients with chronic liver diseases, and 300 healthy controls were enrolled in our study. Serum thioredoxin level was measured by ELISA, and molecular study of thioredoxin domain-containing 5 (TXNDC5) gene polymorphism (rs1225943) polymorphism using real-time polymerase chain reaction by Taqman allele discrimination was done for all subjects. Results: Our study revealed a significant increase in serum thioredoxin levels in patients with HCC compared to chronic liver diseases and healthy controls. Using the Receiver operating characteristic (ROC) curve at the area under the curve (AUC) 0.917 and a cut-off value of > 14.6 U/ml, our overall sensitivity and specificity for the HCC group over the other groups were 86 % and 92.15%, respectively with 92.2% positive predictive value and 54.9% negative predictive value. The molecular study of TXNDC5 gene polymorphism (rs1225943) polymorphism revealed no significant difference between the studied groups. Conclusion: Serum thioredoxin may be used as a promising tumor marker for HCC. Future research is needed to assess its use as a single or combined with other markers in the diagnosis and follow-up of the patients after interventions.