JOURNAL BROWSE
Search
Advanced SearchSearch Tips
Serum Beta-2 Microglobulin: a Possible Marker for Disease Progression in Egyptian Patients with Chronic HCV Related Liver Diseases
facebook(new window)  Pirnt(new window) E-mail(new window) Excel Download
 Title & Authors
Serum Beta-2 Microglobulin: a Possible Marker for Disease Progression in Egyptian Patients with Chronic HCV Related Liver Diseases
Ouda, SM; Khairy, AM; Sorour, Ashraf E; Mikhail, Mikhail Nasr;
  PDF(new window)
 Abstract
Background: Egypt has the highest prevalence of HCV infection in the world (~14.7%). Around 10-15% of HCV-infected persons will advance to cirrhosis within the first 20 years. The incidence of HCC is expected to grow in the next two decades, largely due to HCV related cirrhosis, and detection of HCC at an early stage is critical for a favorable clinical outcome. No simple reliable non-invasive marker has been available till now. B2M, a non-glycosylated polypeptide composed of 99 amino acids, is one of the components of HLA class I molecules on the surfaces of all nucleated cells. It has been reported that the level of serum B2M is elevated in patients with chronic hepatitis C and HCV-related HCC when compared to HCV-negative patients or healthy donors. Determining the clinical utility of serum B2M as a marker for disease progression in Egyptian patients with HCV related chronic hepatitis, cirrhosis and hepatocellular carcinoma was the aim of the present study. Materials and Methods: In this analytical cross sectional study 92 participants were included in 4 equal groups: Group (1) non cirrhotic chronic HCV; Group (2) HCV related liver cirrhosis; Group (3) HCC on top of HCV,; and Group (4) healthy controls. History taking, clinical examination, routine labs and abdominal ultrasound were conducted for all patients, PCR and Metavir scores for group (1) patients, and triphasic CT abdomen and AFP for Group (3) patients. B2M levels were measured in serum with a fully-automated IMX system. Results: The mean serum B2M level of Group (1) was ., Group (2) was , Group (3) was and Group (4) was . Serum B2M levels were significantly higher in diseased than control group (p<0.01) being significantly higher in cirrhosis () and HCC groups () than the HCV group () (p<0.01). There was a significant correlation between B2M Level and ALK, total and direct bilirubin and INR (p<0.05), and a significant inverse correlation between B2M level and albumin, total proteins, HB andWBCS values (p<0.05). There was no significant correlation between B2M level and viral load or Metavir score, largest tumour size or AFP (p>0.05). The best B2M cut-off for HCV diagnosis was 2.6 with a sensitivity of 100%, a specificity of 92%, a positive predictive value (PPV) of 97% and a negative predictive value (NPV) of 100%. The best B2M cut-off for HCC diagnosis was 4.55 which yielded sensitivity, specificity, positive predictive value, negative predictive values of 74%, 62%, 39.5, 87.8% respectively (p-value <0.01) while best cut-off for cirrhosis was 4.9, with sensitivity 74 % and specificity 74%.The sensitivity for HCC diagnosis increased upon B2M and AFP combined estimation to 91%, specificity to 79%, NPV to 95% and accuracy to 83%. Conclusions: Serum B2M level is elevated in HCV related chronic liver diseases and may be used as a marker for HCV disease progression towards cirrhosis and carcinoma.
 Keywords
Serum;B2M-HCV;HCC;progression;marker;
 Language
English
 Cited by
1.
A noninvasive diagnosis of hepatic fibrosis by BioFibroScore® in chronic hepatitis C patients, Journal of Gastroenterology and Hepatology, 2017, 33, 1, 291  crossref(new windwow)
 References
1.
Agha S, Tanaka Y, Saudy N, et al (2004). Reliability of hepatitis C virus core antigen assay for detection of viremia in HCV genotypes 1, 2, 3, and 4 infected blood donors: a collaborative study between Japan, Egypt, and Uzbekistan. J Med Virol, 73, 216-22. crossref(new window)

2.
Ancha Baranova, Priyanka Lal, Aybike Birerdinc, Zobair M Younossi (2011). Non-Invasive markers for hepatic fibrosis. Gastroenterol, 11, 91.

3.
Asanza Cilia G, Carmelo Garcia A-Monezo, Gerardo Clement, et al (1997). Immunohistochemical evidence of immunopathogenetic mechanisms in Chronic Hepatitis C Recurrence After Liver Transplantation. Hepatol, 26, 755-63. crossref(new window)

4.
Behne Tara and Sitki M. Copur (2012). Biomarkers for Hepatocellular Carcinoma. Int J Hepatol, 859076.

5.
Changhoon Yoo, Dok Hyun Yoon, Shinkyo Yoon, et al (2015). Prognostic impact of $\beta$2-microglobulin in patients with non-gastric mucosa-associated lymphoid tissue lymphoma. Leukaemia Lymphoma, 56, 688-93. crossref(new window)

6.
Chatterjeea Reshmi and Mitra Abhisek (2015). An overview of effective therapies and recent advances in biomarkers for chronic liver diseases and associated liver cancer. Int Immunopharmacol, 24, 335-45. crossref(new window)

7.
Chung Raymond T., and Baumert F (2014). Curing chronic hepatitis c. the arc of a medical triumph. N Engl J Med, 370, 1576-8. crossref(new window)

8.
Cuadros Diego F, Branscum Adam J, Miller F. DeWolfe, Abu- Raddad Laith J (2014). Spatial epidemiology of hepatitis C virus infection in Egypt: Analyses and implications. Hepatol, 60, 1150-9. crossref(new window)

9.
ELGendy Saad M, Mohamed Hessien, Mahmoud M. EL Sherbiny (2005). A panel of molecular markers in hepatitis c virus-related hepatocellular carcinoma. J Egyptian Nat Cancer Inst, 17, 270-8.

10.
Feld Jordan J, Kowdley Kris V, Coakley Eoin, et al (2014). Treatment of HCV with ABT-450/r-ombitasvir and dasabuvir with ribavirin. N Engl J Med, 370, 1594-603. crossref(new window)

11.
Flemming Jennifer A, Ju Dong Yang, Eric Vittinghoff, W. Ray Kim, Norah A (2014). Risk prediction of hepatocellular carcinoma in patients with cirrhosis: The Adress HCC risk model. Terrault Cancer, 120, 3485-93. crossref(new window)

12.
Hajarizadeh Behzad, Jason Grebely, Gregory J. Dore (2013). Epidemiology and natural history of HCV infection. Nature Rev Gastroenterol Hepatol, 10, 553-62. crossref(new window)

13.
Hamidreza Abdolsamadi, Peiman Eini , Kieslichova E, et al. (2013). Evaluation of salivary beta-2 microglobulin as HBV proliferation marker in HBS Ag+, HBV DNA PCR+ and HBV DNA PCR- subjects. J Gastroenterol Hepatol, 6, 105-11.

14.
Huang J (2002). HLA in hepatocellular carcinoma. World J Gastroenterol, 8, 1007-9327.

15.
Huckans Marilyn, Bret E. Fuller, Hannah Olavarria, et al (2014). Altered expression of peripheral immune factors is associated with neuro-psychiatric symptom severity in adults with and without chronic hepatitis C virus infection. Brain Behavior, 4, 123-42. crossref(new window)

16.
Kanwal Fasiha, Bacon Bruce R (2012). Does treatment alter the natural history of chronic HCV? Chronic Hepatitis C Virus, 103-12.

17.
Khalid SS, Hamid S, Siddiqui AA, Qureshi A, Qureshi N (2011). Gene profiling of early and advanced liver disease in chronic hepatitis C patient. J Hepatol Int, 5, 782-8. crossref(new window)

18.
Kim JW, Wang XW (2003). Gene expression profiling of preneoplastic liver diseases and liver cancer. A new era for early detection and treatment of these deadly diseases. Carcinogenesis, 24, 363-9. crossref(new window)

19.
Malaguarnera M, Di Fazio I, Ferlito L (2000). Increase of serum beta 2-microglobulin in patients affected by HCV correlated hepatocellular carcinoma. Eur J Gastroenterol Hepatol, 12, 937-9. crossref(new window)

20.
Migliaresia Sergio, Alessandro Bresciania, Luci Ambrosone, et al (2000). Increased serum concentrations of soluble HLA-class I antigens in hepatitis C virus related mixed cryoglobulinaemia. Ann Rheum Dis, 59, 20-5. crossref(new window)

21.
Mourad Wesam, Basuni Ashraf, Fouad Tarekb, et al (2013). The value of PIVKA-II and AFP-L3% in the diagnosis of hepatocellular carcinoma with normal and abnormal AFP levels. Egypt Liver J, 3, 1-5. crossref(new window)

22.
Quiroga J, Martin J, Pardo M, Carreno V (1994). Serum levels of soluble immune factors and pathogenesis of chronic hepatitis C, and their relation to therapeutic response to interferonalpha. Dig Dis Sci, 39, 2485-96 crossref(new window)

23.
Riolobos Laura, Hirata Roli K, Turtle Cameron J, et al (2013). HLA engineering of human pluripotent stem cells. Molecular Therapy, 21, 1232-41. crossref(new window)

24.
Saito Yumi , Nobukui Oba, Syuta Nishinakagawa, et al (2010). Identification of $\beta$2-microgloblin as a candidate for early diagnosis of imaging-invisible hepatocellular carcinoma in patient with liver cirrhosis. Oncol Reports, 23, 1325-30.

25.
Saleh M (2012). Study the expression level of beta 2 microglobulin gene on hepatitis C patients before and after treatment with Interferon. Baghdad Sci J, 9, 504-10.

26.
Tabayoyong William B. and Zavazava Nicholas (2007). Soluble HLA revisited. Leuk Res, 31, 121-5. crossref(new window)

27.
Ward DG, Cheng Y, N'Kontchou G, et al (2006). Preclinical and post-treatment changes in the HCC-associated serum proteome. British J Cancer, 95, 1379-83. crossref(new window)