Assessment of Annexin A2 as A Marker for Diagnosis of Hepatocellular Carcinoma in Compensated and Decompensated Hepatitis C Virus Treated Patients

Abstract

Anti-ANXA2 antibodies were utilized as identification antibodies.Results: With a p-value of <0.001, the ANXA2 level sensitivity and specificity test demonstrated a statistically significant difference in the identification of HCC cases in both compensated and decompensate populations.In comparison to the decompensated group, the ANXA2 level's sensitivity in diagnosing HCC patients was 90% in the compensated status.Regarding AFP and ANXA2 levels, there was a statistically significant distinction (p <0.001) between the two study groups, with a greater mean among the HCC group.Conclusion: The combination of annexin A2 and AFP significantly boosts the diagnostic capability of this promising HCC diagnostic marker.Its serum concentration can be used as an effective, noninvasive tumour marker for HCC identification.

Inclusion criteria:
The investigation involved both males and females who were older than 18.
Participants in the research were HCVtreated people without HCC, Individuals with HCC who have HCV, including those with compensated and decompensated liver cirrhosis, were also included.

Exclusion criteria:
Patients under the age of 18, those with other cancers, those who had viral hepatitis rather than HCV, those with a history of autoimmune illnesses, and those with other significant comorbidities were all excluded from the study.

Ethical consideration:
Patients received comprehensive information from researchers regarding the trial and the marker used.Kruskal-Wallis analysis was used for evaluating multiple independent groups.
The Mann-Whitney test is used for comparing two independent groups.In order to compare two or more qualitative classifications, the chi square test was used.To examine the relationship between parameters, the bivariate Pearson correlation test was used.

Applying the "Receiver Operating
Characteristic" (ROC) curve, tests were performed to determine the sensitivity and specificity of novel tests.
Statistical significance was defined as a P-value of 0.05 or less.

Results:
Table 1 showed that compensated HCV cases had a statistically significant lower https://ejmr.journals.ekb.eg/mean age than decompensated HCV and compensated HCC cases.However, there was no disparity in the sex distribution across the four groups, with a p-value of >0.05 (figure 1).

Table (3):
Comparisons between tumour markers across various study groups.Mean AFP level in study groups

Figure (3) Mean ANXA2 level in study groups
Table 4 shows that there was a statistically significant distinction in AFP and ANXA2 levels between the two groups under consideration, with a greater mean among the HCC group (p-value <0.001).

Mean ANXA2 level in study groups
Table 5 demonstrated that there was no statistically significant variance in the virology assessment between the four groups under investigation with a p-value of >0.05.

Figure (5) Splenomegaly in study groups
According to Table 7, there was no statistically significant variation between the HCC groups (compensated and decompansated) in terms of tumour size, tumour number, or portal vein thrombosis.

Conclusions:
The annexin family, which includes

Recommendations:
Future prospective studies on larger population should be performed to reach a higher diagnostic accuracy.Annexin A2 should also be evaluated in different populations to assess it accuracy.
Further assessment of other biomarkers is recommended to reach higher specificity in assessment of HCC patients.Combination of two or more of non-invasive biomarkers is recommended to reach higher accuracy in assessment of HCC.

Group ( 2 )
) constitutes one of the most prevalent cancers.According to an investigation conducted by Egypt's National Population-Based Cancer Registry Program, liver cancer was the most common type of cancer among Egyptian men (33%), second only to breast cancer among women (13.5%), and first overall (23.8%).Hepatitis C virus (HCV) dissemination was followed by the growth of liver cancer (1).Egypt has the biggest worldwide incidence of hepatitis C virus (HCV) infection (2).Hepatocellular carcinoma (HCC) and cirrhosis are both caused by chronic hepatitis C (CHC), which is a significant risk factor (3).For early detection to enhance the medical outcomes of HCC patients, more sensitive and specific indicators are required.A number of human cancers exhibit an overexpression of annexin A2 (ANXA2), an inducible, calcium-dependent phospholipidbinding protein.An appealing putative https://ejmr.journals.ekb.eg/receptor for enhanced plasmin production on the surface of tumour cells is annexin A2.In healthy liver tissues and tissues affected by chronic hepatitis, ANXA2 is essentially undetectable (4).Consequently, the current study's objective was to assess the amount of annexin A2 in compensated and decompensated HCV-treated patients in order to diagnosis HCC because it is a useful diagnostic and predictive marker for early HCC in patients with chronic hepatitis C. included in this study and divided into two groups.Group (1): 40 HCV-treated patients, 20 of whom had compensated liver cirrhosis and 20 did not, were free of HCC.: 40 HCV patients with HCC, 20 of whom had compensated liver cirrhosis and 20 did not.Between November 2021 and May 2022, patients were chosen from the internal medicine department of the Beni-Suef university hospital according on the preceding inclusion and exclusion criteria:

Figure ( 2 )
Figure (2) Mean AFP level in study groups

Annexin
invasion, and metastasis.Contrary to normal or cirrhotic tissue, HCC has higher levels of ANXA2 expression.The diagnostic power of Annexin A2, a promising HCC diagnostic marker, when combined with AFP is significantly increased.Its serum concentration can be used as an effective, non-invasive tumour marker for HCC identification.

https://ejmr.journals.ekb.eg/
assessment, To assess the quantitative variations between more than two independent variations in quantitative data, a one-way ANOVA test was used.

Table 1 :
Comparisons of demographic characteristics in different study groups.

Table 2 :
Correlations between laboratory tests conducted among the study groups.

Table 3
revealed that the AFP and ANXA2 values between the four study groups differed statistically and significantly (p-value < 0.05), with the decompensated HCC group having an elevated mean (figures 2 and 3).

Table ( 5
): comparisons of virology findings across various study groups.

Table ( 6
): Comparisons of clinical findings in different study groups.
a: significance difference between comp.& decomp HCV groups b: significance difference between comp.& decomp HCC groups c: significance difference between comp.HCV& HCC groups d: significance difference between decomp HCV&HCC groups Figure (4) Ascites in study groups

Table (
Correlation between ANXA2 with routine investigations among HCV cases. 7): Comparisons of tumor characteristics in different HCC groups.andTLCwithp-value <0.05, indicating that a rise in TLC will be associated with a higher levels in ANXA2 content.However, there was no statistically significant link between ANXA2 level and all other HCV case investigations with p-value >0.05.No SplenomegalySplenomegaly https://ejmr.journals.ekb.eg/Table (8):

Table 9
Sensitivity and specificity tests for the ANXA2 level showed that neither research group (HCV or HCC) could reliably diagnose the condition of decomposition (figures 6 and 7).Sensitivity and specificity of ANXA2 in diagnosis of decompensate degree of both HCV and HCC cases.
demonstrated that no statistically significant relationship existed between the ANXA2 value and any of the other HCC cases examined with a p-value greater than 0.05.Table (9): Correlation between ANXA2 with routine investigations among HCC cases.NS https://ejmr.journals.ekb.eg/ Figure (6): ROC curve for ANXA2 level in diagnosis of decompensated condition cases among (HCV)