Evaluating serum extra spindle pole bodies-like 1 protein vs p53 antibody for hepatitis B virus-related hepatocellular carcinoma diagnosis.

Abstract

Background: Hepatitis B virus (HBV) infection is a leading cause of global hepatocellular carcinoma (HCC). Conventional biomarkers such as alpha-fetoprotein (AFP) demonstrate suboptimal sensitivity and specificity. Emerging evidence suggests that serum extra spindle pole bodies like 1 (ESPL1) protein and p53 antibody may improve diagnostic accuracy.

Aim: To assess and compare the diagnostic performance of serum ESPL1 protein and p53 antibody in HBV-related HCC (HBV-HCC).

Methods: This case-control study from the First Affiliated Hospital of Guangxi Medical University enrolled 30 patients with chronic hepatitis B (CHB), 30 with HBV-related liver cirrhosis (HBV-LC), 55 with HBV-HCC, and 30 healthy controls. Serum ESPL1 protein and p53 antibody levels were quantified via ELISA. Diagnostic performance was evaluated using receiver operating characteristic (ROC) curve analysis, including sensitivity, specificity, and correlation with AFP.

Results: Serum ESPL1 protein levels progressively increased across disease stages (CHB: 89.9 ng/L; HBV-LC: 188.83 ng/L; HBV-HCC: 317.63 ng/L), with a significantly higher area under the ROC curve (AUC = 0.917) than either p53 antibody (AUC = 0.725) or AFP (AUC = 0.678). p53 antibody levels were significantly elevated only in the HBV-HCC group. ESPL1 demonstrated superior sensitivity and concordance with histopathological findings. A significant correlation between ESPL1 and p53 antibody levels was observed exclusively in the HBV-HCC group (r = 0.320, P = 0.017), suggesting potential interplay in malignant transformation.

Conclusion: Serum ESPL1 protein, a promising biomarker for early HBV-HCC detection, outperforms p53 antibody in diagnostic reliability. Higher ESPL1 levels correlate with increased HCC risk in chronic HBV patients.