Diagnostic value of betatrophin for hepatocellular carcinoma in patients with liver cirrhosis

Introduction
Alpha-fetoprotein (AFP) is the most widely used marker of hepatocellular carcinoma (HCC). Betatrophin is a hormonal protein secreted by the liver and adipose tissue, with metabolic and antiproliferative functions. The aim of this study was to evaluate the betatrophin concentration in patients with HCC and liver cirrhosis.

Material and methods
The study enrolled 96 patients with HCC (group 1), 81 with cirrhosis (group 2), and 13 with non-advanced liver disease (group 3, control). Betatrophin levels were tested using the ELISA test (AVISCERA BIOSCIENCE). The Mann-Whitney U-test, the Kruskal-Wallis test, and Spearman’s correlation were used in the statistical analysis.

Results
Group 1 comprised 71 men and 25 women with a mean age of 61.5 years. Group 2 consisted of 57 men and 24 women with a mean age of 58.5 years. The control group included 7 men and 6 women, with a mean age of 46 years. The median AFP level in group 1 was 393 ng/ml and the betatrophin level was 25 ng/ml. In group 2, AFP averaged 4.5 ng/ml, and betatrophin was 21.9 ng/ml. In group 3, AFP was 3.6 ng/ml, and betatrophin was 7.6 ng/ml. The optimal betatrophin threshold for predicting HCC was established at 30.23 ng/ml, with sensitivity of 64.0%, specificity of 62.5%, PPV of 37.2%, and NPV of 83.3%. ROC curves were assessed using the DeLong method. Betatrophin (AUC = 0.642, p = 0.0326) showed significantly better performance than AFP (AUC = 0.584, p = 0.117) in detecting HCC in women.

Conclusions
Betatrophin is a promising diagnostic marker for HCC in cirrhotic patients, particularly women.