Supplementary Table S4: The AUC of these four TAAbs for identifying HBV-HCC patients from CHB patients ranged from 0.693-0.739. Among them, anti-DUSP6 showed the highest diagnostic ability, with an AUC of 0.739 (95% CI [confidence interval]: 0.694-0.785). The diagnostic capability of anti-PCNA was the poorest, with an AUC of 0.693 (95% CI: 0.645-0.741). The AUC of four candidate TAAbs in differentiating between HBV-HCC and HBV-LC patients ranged from 0.589 to 0.624. Among them, anti-PCNA had the most diagnostic capacity, with an AUC of 0.624 (95% CI: 0.569-0.679). Anti-CDC37L1 had the least diagnostic capability, with an AUC of 0.589 (95% CI: 0.533-0.645).
Funding
Key Scientific Research Project of Colleges and Universities in Henan Province
Zhengzhou Municipal Science and Technology Bureau (Zhengzhou Science and Technology Bureau)
Henan Provincial Science and Technology Research Project (河南省科技攻关项目)
ARTICLE ABSTRACT
The purpose of this study was to identify biomarkers associated with hepatitis B virus-associated hepatocellular carcinoma (HBV-HCC) and to develop a new combination with good diagnostic performance. This study was divided into four phases: discovery, verification, validation, and modeling. A total of four candidate tumor-associated autoantibodies (TAAb; anti-ZIC2, anti-PCNA, anti-CDC37L1, and anti-DUSP6) were identified by human proteome microarray (52 samples) and bioinformatics analysis. Subsequently, these candidate TAAbs were further confirmed by indirect ELISA with two testing cohorts (120 samples for verification and 663 samples for validation). The AUC for these four TAAbs to identify patients with HBV-HCC from chronic hepatitis B (CHB) patients ranged from 0.693 to 0.739. Finally, a diagnostic panel with three TAAbs (anti-ZIC2, anti-CDC37L1, and anti-DUSP6) was developed. This panel showed superior diagnostic efficiency in identifying early HBV-HCC compared with alpha-fetoprotein (AFP), with an AUC of 0.834 [95% confidence interval (CI), 0.772–0.897] for this panel and 0.727 (95% CI, 0.642–0.812) for AFP (P = 0.0359). In addition, the AUC for this panel to identify AFP-negative patients with HBV-HCC was 0.796 (95% CI, 0.734–0.858), with a sensitivity of 52.4% and a specificity of 89.0%. Importantly, the panel in combination with AFP significantly increased the positive rate for early HBV-HCC to 84.1% (P = 0.005) and for late HBV-HCC to 96.3% (P < 0.001). Our findings suggest that AFP and the autoantibody panel may be independent but complementary serologic biomarkers for HBV-HCC detection.
We developed a robust diagnostic panel for identifying patients with HBV-HCC from patients with CHB. This autoantibody panel provided superior diagnostic performance for HBV-HCC at an early stage and/or with negative AFP results. Our findings suggest that AFP and the autoantibody panel may be independent but complementary biomarkers for HBV-HCC detection.
