Serum thioredoxin is a diagnostic marker for hepatocellular carcinoma

// Jun Li 1, * , Zhang-Jun Cheng 2, * , Yang Liu 1, * , Zhen-Lin Yan 1 , Kui Wang 1 , Dong Wu 1 , Xu-Ying Wan 3 , Yong Xia 1 , Wan Yee Lau 1, 4 , Meng-Chao Wu 1 , Feng Shen 1 1 Department of Hepatic Surgery, The Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China 2 Department of General Surgery, The Zhongda Hospital, Southeast University, Nanjing, China 3 Department of Chinese Traditional Medicine, The Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China 4 Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong * These authors have contributed equally to this work Correspondence to: Feng Shen, e-mail: shenfengehbh@sina.com Keywords: thioredoxin, hepatocellular carcinoma, biomarker, diagnosis, chinese Received: December 14, 2014      Accepted: February 08, 2015      Published: March 19, 2015 ABSTRACT Here we found that serum levels of thioredoxin were increased in patients with hepatocellular carcinoma (HCC). The optimum diagnostic cutoff for thioredoxin was 20.5 ng/mL (area under curve AUC 0.946 95% CI 0.923–0.969 in the training cohort; 0.941 0.918–0.963 in the validation cohort). High serum concentrations of thioredoxin differentiated HCC from chronic liver diseases and cirrhosis (0.901 0.875–0.923 in the training cohort; 0.906 0.870–0.925 in the validation cohort). Furthermore, a higher proportion of patients with very early HCC had positive results for thioredoxin than for alpha-Fetoprotein (AFP) (73.7% VS.31.6%; P < 0.0001). Among AFP-negative patients with very early HCC, 18 (69.2%) of 26 had positive thioredoxin results. Our results indicate that serum thioredoxin complements measurement of AFP in the diagnosis of HCC, especially in very early disease. Combined model (thioredoxin and AFP) showed a significantly greater discriminatory ability as compared with those markers alone.