Identification and Validation of Novel Biomarkers for HBV-Associated Hepatocellular Carcinoma, Liver Fibrosis/Cirrhosis and Chronic Hepatitis: A Case Control Study

BackgroundAt present, there are no accurate diagnostic biomarkers for distinguishing among hepatitis B virus (HBV)-related liver diseases. This research aimed to identify and validate a novel biomarker panel in patients with HBV-related hepatocellular carcinoma (HCC), liver fibrosis/liver cirrhosis (LF/LC) and chronic hepatitis B (CHB).MethodsTranscriptomics sequencing was conducted on a total of 19 liver tissues of the four groups. The hub mRNAs were identified using weighted gene co-expression network analysis (WGCNA) and short time-series expression miner (STEM) method. The expression levels of selected mRNAs and proteins were assessed by quantitative real-time polymerase chain reaction (qRT-PCR) using both liver tissues and peripheral blood mononuclear cells (PBMCs) and immunohistochemical (IHC) staining in liver tissues, respectively. Then, the expression activities of the screened targets were detected by enzyme-linked immunosorbent assay (ELISA) using the plasma samples from 200 and 400 subjects in the validation and testing sets, respectively. Finally, receiver operating characteristic (ROC) curve analysis was carried out to evaluate the diagnostic performance of each mRNA biomarker.ResultsSTEM analysis revealed 25 mRNAs exhibited an increasing trend in the four groups; while 9 hub mRNAs were identified by using WGCNA. Of note, the results of qRT-PCR and immunohistochemical analyses demonstrated that SHC adaptor protein 1 (SHC1), SLAM family member 8 (SLAMF8), and interleukin-32 (IL-32) exhibited a gradually increasing trend in the four groups. Subsequent ELISA tests on the validation cohort demonstrated that the plasma levels of SHC1, SLAMF8 and IL-32 were remarkably elevated in HCC group compared to the remaining three groups. Furthermore, a diagnostic model APFSSI (age, PLT, ferritin, SHC1, SLAMF8 and IL-32) was established to distinguish HCC from LF/LC (AUC=0.904), LF/LC from CHB (AUC=0.924), and CHB from healthy controls (AUC=0.966). Finally, the results in the test set were consistent with those in the validation set. ConclusionsSHC1, SLAMF8 and IL-32 can differentiate among HCC patients, LF/LC patients, CHB patients and healthy controls. More importantly, the combination of age, PLT, ferritin, SHC1, SLAMF8, and IL-32 (APFSSI model) greater improves the diagnostic accuracy of HBV-associated liver diseases.