Clinical and Experimental Hepatology
eISSN: 2449-8238
ISSN: 2392-1099
Clinical and Experimental Hepatology
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abstract:
Original paper

Annexin A2 as a marker for hepatocellular carcinoma detection among patients with hepatitis C virus-related liver cirrhosis after HCV treatment using directly acting antivirals

Mohamed S. Shater
1
,
Amr A. Abd Elmoety
1
,
Yousri A. A. Rostom
1
,
Eman Z. Elkemary
1
,
Hyam M. Helal
1
,
Ahmed Kamal
1

  1. Alexandria University, Egypt
Clin Exp HEPATOL 2025; 11, 4
DOI: https://doi.org/10.5114/ceh.2025.154172
Online publish date: 2025/10/14
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Introduction
Hepatocellular carcinoma (HCC) is considered the sixth most prevalent malignant tumor, while it ranks first in Egypt. Early detection of HCC is of great value, as early stages can be treated with curative modalities. Current surveillance programs depend on ultrasonography and a-fetoprotein (AFP) measurement, but both have notable limitations. This study aimed to investigate the potential role of annexin A2 in HCC detection.

Material and methods
The present study included four groups: Group A: early hepatocellular carcinoma, BCLC stages 0 and A; Group B: advanced hepatocellular carcinoma, BCLC stage C; Group C: liver cirrhosis without HCC; Group D: healthy participants as a control group. Chronic hepatitis C was the cause of cirrhosis in three groups (A, B, and C). All of them attained a sustained virological response (SVR) after receiving treatment with direct-acting antiviral medications (DAAs). Both serum AFP and annexin A2 were measured in all included subjects.

Results
One hundred subjects were included, 25 in each group. Annexin A2 levels were significantly higher in early- and advanced-stage HCC participants. Serum annexin A2 level was an excellent discriminator of early HCC, with an area under the ROC curve (AUC) of 0.934. The cut-off point > 7.7 ng/ml had a sensitivity of 96.00%, a specificity of 88%, a positive predictive value (PPV) of 88.9%, and a negative predictive value (NPV) of 95.7% (p < 0.001).

Conclusions
Serum annexin A2 is a promising biomarker that can improve the sensitivity of HCC detection among patients with liver cirrhosis after HCV eradication using DAAs.

keywords:

hepatocellular carcinoma, hepatitis C, surveillance, a-fetoprotein, annexin A2
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