We used a sandwich ELISA to examine the serum clusterin

concentrations in these subjects. Our results showed that the median (25–75th percentile) levels of serum clusterin had no difference among G1 [120.24 (104.03, 149.47) µg/mL], G2 [146.66 (114.70, 191.80) µg/mL] and G3 [139.89 (104.73, 175.18) µg/mL] (G1 vs G2: P = 0.200; G1 vs G3: P = 0.959; Cobimetinib G2 vs G3: P = 0.890). However, serum clusterin levels in G5 [91.92 (61.62, 115.33) µg/mL] were significantly lower than that in G1, G2 and G3 (P < 0.01), but they were significantly higher than that in G4 [34.50 (21.31,45.05) µ/mL,] (P < 0.001) (Fig. 1). In our study, further analysis demonstrated that the serum clusterin levels in liver cirrhosis patients Rapamycin molecular weight [34.50 (21.31, 45.05) µg/mL] were significantly lower than that in either HCCs with AFP ≤ 25 ng/mL [79.52 (59.71, 114.57) µg/mL] or HCCs with AFP > 25 ng/mL [93.39 (61.64, 117.33) µg/mL] (P < 0.001). But no significant difference of clusterin levels was observed between the two groups of HCC with different AFP values (Fig. 2). In addition, the serum clusterin levels in liver cirrhosis patients [34.50 (21.31, 45.05) µg/mL] were also significantly lower than that in < 5 cm HCC [98.91 (64.72, 128.68) µg/mL], 5–10 cm HCC [77.55 (59.28, 114.43) µg/mL] and > 10 cm HCC patients [106.37 (65.82,

122.55) µg/mL] (P < 0.001). But there was no significant difference of clusterin levels between the three groups of HCC with different tumor sizes. (Fig. 3)

In this study, learn more the median (25–75th percentile) AFP levels in liver cirrhosis (n = 29) were 6.50 (2.78, 20.73) ng/mL, which were significantly lower than that in HCC (n = 76) [69.52 (10.59, 11 033.25) ng/mL] (P < 0.001). The ROC curves were plotted to identify a cutoff value that would best distinguish HCC (G4, n = 76) from liver cirrhosis (G3, n = 29) (Fig. 4). The optimal cutoff values for serum clusterin and serum AFP were 50 µg/mL and 15 ng/mL, respectively. The sensitivity and specificity for clusterin was 91% and 83% and for AFP was 67% and 76%, respectively. The positive predictive value (PPV) and negative predictive value (NPV) was 93% and 77% for clusterin and 88% and 47% for AFP, respectively (Table 2). The AUC for clusterin was 0.937 (S.E. = 0.025, 95% CI = 0.888–0.987) compared with 0.781 (S.E. = 0.045, 95% CI = 0.692–0.870) for AFP. The AUC indicated significant difference in sensitivity and specificity between serum clusterin and AFP for differentiating HCC from liver cirrhosis (P < 0.05). This indicated that the optimal value (50 µg/mL) of serum clusterin showed a higher sensitivity and specificity than that (15 ng/mL) of serum AFP. In addition, when the cutoff value of AFP increased from 15 ng/mL to 400 ng/mL, the specificity and PPV increased, but the sensitivity and NPV decreased (Table 2).