The Utility of Serum Neuropilin 1 as a Diagnostic Biomarker for Hepatocellular Carcinoma in Egyptian Cirrhotic Patients

Background: In recent decades, hepatocellular carcinoma (HCC) has become the prevailing type of primary hepatic cancer, with its incidence rising dramatically. Many HCC patients are identified at an advanced, inoperable stage, limiting curative treatment options and resulting in poor survival rates. Aim: The study aimed to evaluate the role of Neuropilin 1 (NRP1) as a new serum diagnostic marker for hepatocellular carcinoma in cirrhotic Egyptian patients. Subjects and methods: This case control study encompassed 60 individuals, aged 18 and above, recruited from The Hepatology and Internal Medicine Clinics and Hospital Units between January 2024 and June 2024 at Ain Shams University Hospital. The patients were classified as follows: Group 1 consisted of 30 HCC patients through alpha-fetoprotein testing and imaging. Group 2 comprised 30 cirrhotic patients, devoid of HCC, matched and categorized following the Child-Pugh scoring system. Results: This investigation of Egyptian patients found that HCC typically emerges in the sixth decade of life and is often linked to liver cirrhosis. Patients with HCC exhibited significantly elevated serum alpha-fetoprotein (AFP) levels. Moreover, NRP1, a recently discovered biomarker, showed a substantial increase in HCC patients compared to cirrhosis patients. This elevation correlated strongly with liver function indicators (AST, ALT, AFP & albumin) and Barcelona and Child-Pugh scores. NRP1 demonstrated superior sensitivity (96.67%) and specificity (80%) in diagnosing HCC, unlike AFP, highlighting its capability as a more effective indicator for diagnosing HCC. Conclusion: Serum NRP1 levels were notably elevated in HCC patients. In contrast, cirrhotic patients showed only a slight increase in NRP1 levels compared to the HCC group.