BACKGROUND Hepatocellular carcinoma(HCC)is a leading cause of cancer-related mortality worldwide,with hepatitis B virus(HBV)infection serving as a significant etiological factor in endemic regions.Alpha-fetoprotein(AF...BACKGROUND Hepatocellular carcinoma(HCC)is a leading cause of cancer-related mortality worldwide,with hepatitis B virus(HBV)infection serving as a significant etiological factor in endemic regions.Alpha-fetoprotein(AFP),the most commonly used biomarker,has limited sensitivity,particularly in AFP-negative HCC.Recent studies have identified origin recognition complex subunit 1(ORC1)and extra spindle pole bodies-like 1(ESPL1)as promising serum biomarkers,both linked to HBV DNA integration,a mechanism known to drive hepatocarcinogenesis.AIM To assess serum ORC1’s diagnostic value for HBV-HCC and its link to S gene integration.METHODS In this case-control study,479 HBV-infected patients were enrolled,including 20 hepatitis B,154 with HBV-related cirrhosis,and 96 with HBV-HCC.The control group comprised 73 individuals:29 with non-HBV-HCC and 44 healthy participants.Serum ORC1 and ESPL1 were measured by enzyme-linked immunosorbent assay.HBV integration sites were identified via whole-genome sequencing.Diagnostic performance was assessed using receiver operating characteristic analysis,including in AFP-negative patients.RESULTS HBV integration near the ORC1 locus(chromosome 1p32.3)was detected in 71.4%of HBV-HCC tissues.Serum ORC1 levels were significantly higher in HBV-infected patients than in non-HBV-infected controls(980.11 ng/L vs 746.82 ng/L,P<0.05)and in HBV-HCC compared with non-HBV-HCC(1077.07 ng/L vs 749.54 ng/L,P<0.05).Serum ORC1 and ESPL1 were elevated in HBV-HCC regardless of AFP status,and detected 64.8%and 73.2%of AFP-negative cases,respectively.The combined panel of ORC1[Area under receiver operating characteristic curve(AUC)=0.587],ESPL1(AUC=0.776),and AFP(AUC=0.844)achieved an AUC of 0.887,significantly higher than any single marker(P<0.05),with a sensitivity of 84.44%,specificity of 84.19%,and a negative predictive value of 94.91%.CONCLUSION Serum ORC1,driven by HBV integration,is a promising biomarker especially for AFP-negative HBV-HCC.Its combination with ESPL1 and AFP significantly improves early detection.展开更多
文摘BACKGROUND Hepatocellular carcinoma(HCC)is a leading cause of cancer-related mortality worldwide,with hepatitis B virus(HBV)infection serving as a significant etiological factor in endemic regions.Alpha-fetoprotein(AFP),the most commonly used biomarker,has limited sensitivity,particularly in AFP-negative HCC.Recent studies have identified origin recognition complex subunit 1(ORC1)and extra spindle pole bodies-like 1(ESPL1)as promising serum biomarkers,both linked to HBV DNA integration,a mechanism known to drive hepatocarcinogenesis.AIM To assess serum ORC1’s diagnostic value for HBV-HCC and its link to S gene integration.METHODS In this case-control study,479 HBV-infected patients were enrolled,including 20 hepatitis B,154 with HBV-related cirrhosis,and 96 with HBV-HCC.The control group comprised 73 individuals:29 with non-HBV-HCC and 44 healthy participants.Serum ORC1 and ESPL1 were measured by enzyme-linked immunosorbent assay.HBV integration sites were identified via whole-genome sequencing.Diagnostic performance was assessed using receiver operating characteristic analysis,including in AFP-negative patients.RESULTS HBV integration near the ORC1 locus(chromosome 1p32.3)was detected in 71.4%of HBV-HCC tissues.Serum ORC1 levels were significantly higher in HBV-infected patients than in non-HBV-infected controls(980.11 ng/L vs 746.82 ng/L,P<0.05)and in HBV-HCC compared with non-HBV-HCC(1077.07 ng/L vs 749.54 ng/L,P<0.05).Serum ORC1 and ESPL1 were elevated in HBV-HCC regardless of AFP status,and detected 64.8%and 73.2%of AFP-negative cases,respectively.The combined panel of ORC1[Area under receiver operating characteristic curve(AUC)=0.587],ESPL1(AUC=0.776),and AFP(AUC=0.844)achieved an AUC of 0.887,significantly higher than any single marker(P<0.05),with a sensitivity of 84.44%,specificity of 84.19%,and a negative predictive value of 94.91%.CONCLUSION Serum ORC1,driven by HBV integration,is a promising biomarker especially for AFP-negative HBV-HCC.Its combination with ESPL1 and AFP significantly improves early detection.
