Alpha-fetoprotein and serum golgi phosphoprotein 2 are equally discriminative in detecting early hepatocellular carcinomas #

Li et al. have analyzed golgi phosphoprotein 2 (GOLPH2) serum levels in a cohort of patients with liver cirrhosis, healthy controls, and patients with hepatocellular carcinoma (HCC). They found elevated serum levels of GOLPH2 (sGOLPH2) in early HCC cases. From their findings, the authors conclude that sGOLPH2 is a better marker than alpha-fetoprotein (AFP) for detection of early HCC. In our patients, no significant differences between controls, viral hepatitis (HBV/HCV), and HCC (independent of etiology) were found. However, HCC arising in a hepatitis C virus background had significantly higher GOLPH2 serum levels than healthy controls.1 The findings of Li, Wu, and Fan prompted us to conduct an extended analysis of our dataset. No significant difference of sGOLPH between early HCCs (T1/2 [United Network for Organ Sharing–modified Tumor-Node-Metastasis stages 1 and 2]) and late HCCs (T3/4) was seen. Li et al. had comparable levels of sGOLPH2 in healthy individuals and patients with liver cirrhosis. Although we did not compare cirrhosis with early HCCs, we too see a trend (P = 0.097) of rising values when comparing controls (median 5.7 mg/L) to early HCCs (median 15.8 mg/L). With regard to the notion of Li et al. that sGOLPH2 is a superior marker of early HCC, we find AFP (cutoff 10 ng/mL) and sGOLPH2 (cutoff 10 mg/L) to be equally discriminative and recommend the complementary use of both markers to improve the detection and surveillance of HCCs. We agree that larger studies of GOLPH2 should be pursued to define the role of GOLPH2 in serum-based diagnosis and monitoring of HCC. Ideally, this should be embedded in a prospective, randomized controlled trial. Marc-Oliver Riener*, Frank Stenner , Heike Liewen , Claus Hellerbrand , Marcus Bahra§, Glen Kristiansen*, * Department of Pathology, University Hospital Zürich, Zürich, Switzerland, Department of Oncology, University Hospital Zürich, Zürich, Switzerland, Department of Internal Medicine I, University of Regensburg, Regensburg, Germany, § Visceral and Transplantation Surgery, University Hospital Charité, Berlin, Germany.