A preliminary study of plasma cyclase-associated protein 2 as a novel biomarker for early stage and alpha-fetoprotein negative hepatocellular carcinoma patients

Identification of Cyclase-Associated Protein-2 as a Novel Biomarker for Early- Stage Hepatocellular Carcinoma

“…Nevertheless, Early-stage HCC patients had no significant elevation in AFP levels. This finding could imply a role of CAP2 in the prediction of HCC and coincided with a previous study in which the authors proposed that plasma CAP2 level is a promising biomarker complementary to AFP in diagnosing HCC [32].…”

“…Recently, numerous biomarkers had been proposed to predict earlystage HCC as well as AFP-negative HCC patients such as desgamma-carboxy prothrombin (DCP) (also known as Prothrombin Induced by Vitamin K Absence II: PIVKA II), Lens culinaris-agglutinin-reactive fraction of AFP (AFP-L3) [34], Glypican-3 (GPC3) [35], fucosylated haptoglobin [36], fucosylated paraoxonase 1 (FUC-PON1) [37]; Heat shock proteins (HSP70) [38], Annexin A2 (ANXA2) [39], microRNAs panel (miRNAs) [40], Eag1 channels [41], Transforming Growth Factor-Beta [42], Osteopontin (OPN) [43] and CAP2 [32,33]. The combination of PIVKA-II, the sensitivity of which was 48.9% in HCC patients, with AFP or AFP-L3 significantly improved its diagnostic performance [34].…”

“…Chen et al suggested that CAP2 has a pivotal and superior role in differentiating HCC from LC being had a better sensitivity at 82.6% vs. 59.3%, higher AUC at 0.86 vs. 0.75 than AFP [32]. This evidence coincides with the current study in which, CAP2 had a better diagnostic value than AFP, a significantly higher AUC (95%CI) at 0.86 (0.79-0.93) vs. 0.75 (0.65-0.85), a significantly higher Sensitivity of (81.5% vs. 62%), and a higher positive predictive value of 86.3% vs. 79.5%.…”

New nomogram predicts the recurrence of hepatocellular carcinoma in patients with negative preoperative serum AFP subjected to curative resection

“…Siripongsakun et al and Zhang et al suggested that the postoperative measurement of AFP in these HCC populations may not be helpful and should be omitted because of its poor sensitivity. Although several markers may be used in the prediction and diagnosis of HCC, including AFP‐L3, glypican‐3, cyclase‐associated protein 2 (CAP2), AFP‐mRNA, and the half‐life of serum AFP, there are many limitations to the use of these markers in clinical practice . Many staging systems have been used for the classification and prognostication of HCC, including the TNM system, Okuda score, Japan Integrated Staging score, CLIP score, and BCLC stage .…”

“…Although several markers may be used in the prediction and diagnosis of HCC, including AFP-L3, glypican-3, cyclase-associated protein 2 (CAP2), AFP-mRNA, and the half-life of serum AFP, there are many limitations to the use of these markers in clinical practice. [11][12][13][14] Many staging systems have been used for the classification and prognostication of HCC, including the TNM system, Okuda score, Japan Integrated Staging score, CLIP score, and BCLC stage. [15][16][17][18] Nonetheless, these classification criteria vary considerably, present controversial results, and are divided into different groups with varying prognostic results and therapeutic strategies.…”