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Validity of serum amyloid A and HMGB1 as biomarkers for early diagnosis of gastric cancer

Authors Ghweil AA, Osman HA, Hassan MH, Sabry AMM, Mahdy RE, Ahmed ARH, Okasha A, Khodeary A, Ameen HH

Received 10 March 2019

Accepted for publication 11 June 2019

Published 8 January 2020 Volume 2020:12 Pages 117—126

DOI https://doi.org/10.2147/CMAR.S207934

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Editor who approved publication: Dr Antonella D'Anneo


Ali A Ghweil,1 Heba A Osman,1 Mohammed H Hassan,2 Abeer MM Sabry,3 Reem E Mahdy,4 Ahmed RH Ahmed,5 Ahmed Okasha,6 Ashraf Khodeary,7 Hesham H Ameen8

1Tropical Medicine and Gastroenterology Department, Faculty of Medicine, South Valley University, Qena, Egypt; 2Department of Medical Biochemistry, Faculty of Medicine, South Valley University, Qena, Egypt; 3Internal Medicine and Gastroenterology Department, Faculty of Medicine, Helwan University, Helwan, Egypt; 4Internal Medicine Department, Faculty of Medicine, Assiut University, Assiut, Egypt; 5Pathology Department, Faculty of Medicine, Sohag University, Sohag, Egypt; 6Radiology Department, Faculty of Medicine, South Valley University, Qena, Egypt; 7Clinical Pathology Department, Faculty of Medicine, Sohag University, Sohag, Egypt; 8Clinical Pathology Department, Faculty of Medicine, Al-Azhar University (Assiut Branch), Assiut, Egypt

Correspondence: Mohammed H Hassan
Department of Medical Biochemistry, Faculty of Medicine, South Valley University, Qena 83523, Egypt
Tel +20 109 847 3605
Email mohammedhosnyhassaan@med.svu.edu.eg

Background and aim: Gastric carcinomais a frequent neoplasm with poor outcome, and its early detection would improve prognosis. This study was designed to evaluate the possible use of new biomarkers, namely SAA and HMGB1, for early diagnosis of gastric cancer.
Methods: A total of 100 patients presenting with gastric symptoms were included. All patients underwent upper endoscopic evaluation, histopathological diagnosis and serum CEA, SAA, and HMGB1 measurements.
Results: Patients were classed endoscopically with neoplastic, inflammatory, and normal-appearing gastric mucosa: 50, 25, and 25 patients, respectively. Histologically, half the patients had chronic gastritis and the remaining cases gastric carcinoma of diffuse (n=28) or intestinal (n=22) type. SAA at cutoff of 18.5 mg/L had the best validity to differentiate gastritis from gastric carcinoma, with AUC, sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) of 0.99, 98%, 100%, 100%, and 98%, respectively, followed by HMGB1 at cutoff of 14.5 pg/μL, with AUC, sensitivity, specificity, PPV, and NPV of 0.91, 70%, 96%, 94.6%, and 76.2%, respectively. Sensitivity, specificity, PPV, and NPV of serum CEA at cutoff of 2.9 ng/mL to differentiate gastritis from gastric carcinoma were 42%, 72%, 60%, and 55.4%, respectively, with AUC of 0.53. Nonetheless, higher serum levels of both SAA and HMGB1 reflected higher tumor grade (P=0.027 and P=0.016, respectively) and advanced tumor stage (P-OBrk-0.001 for both).
Conclusion: Serum levels of both SAA and HMGB1 could be of great value for early diagnosis of gastric carcinoma, comparable to the diagnostic role of serum CEA, which is not valid for early diagnosis of gastric cancer.

Keywords: gastric carcinoma, early detection, SAA, HMGB1, CEA


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