Clinical Relevance of Serum Endoglin Level in Egyptian Hepatocellular Carcinoma Patients

Background: In hepatocellular carcinoma (HCC), preferential expression of endoglin on endothelial cells of the tumor vasculature versus neoplastic cells has led to the suggestion that it originates from the neovasculature and plays an important role in angiogenesis. Our study aimed to evaluate the role of serum endoglin in the diagnosis of HCC and to correlate it with other studied prognostic markers. Methods: Sixty hepatocellular carcinoma patients were studied, 60 cirrhotic patients and 45 matched healthy controls. Liver function tests, alpha fetoprotein (alpha FP) and serum endoglin levels were determined. Results: The study revealed a significant increase in alpha FP and endoglin in patients with liver disease compared to controls and in HCC patients compared to cirrhotic ones. There was a positive correlation between both biomarkers and stages of HCC, whereas no significant correlation between endoglin and alpha FP or between both of them and Child Pugh's classification was seen. At a cutoff value of 20 ng/mL, the sensitivity of alpha FP was 75\% and the specificity was 90\%, in differentiating HCC from cirrhosis. At a 7.5 ng/mL cutoff, the sensitivity of endoglin was 70\% and specificity was 65\%. On combination of both biomarkers, the sensitivity was increased to 85\%. Conclusions: Serum endoglin is a useful complementary biomarker in the diagnosis of HCC. (Clin. Lab. 2012;58:1023-1028. DOI: 10.7754/Clin.Lab.2012.111204)