Expression characteristics and diagnostic value of annexin A2 in hepatocellular carcinoma

Table 1 Relative quantity of hepatic annexin A2 mRNA and annexin A2 expression in hepatocellular carcinoma-, adjacent-, and distant-cancerous tissues (n = 30) (mean ± SD)

Group	CtANXA2	Ctβ-actin	∆Ct	2-∆∆Ct	Annexin A2 intensity				Z
					-	+	++	+++
HCC tissues	21.63 ± 0.09	21.19 ± 0.07	0.44 ± 0.06	1	0	1	7	22
Adjacent cancerous tissues	24.29 ± 0.09	22.60 ± 0.08	1.70 ± 0.12	0.43 ± 0.10b	3	16	11	0	6.113b
Distant cancerous tissues	24.71 ± 0.06	22.13 ± 0.06	2.57 ± 0.07	0.23 ± 0.07b	30	0	0	0	7.328b

^bP < 0.01 vs the hepatocellular carcinoma (HCC) tissue group. -: Negative staining; +: Weak staining; ++: Moderate staining; +++: Diffuse positive staining.

Table 2 Serum annexin A2 and α-fetoprotein levels in 241 patients with liver diseases (mean ± SD)

Group	n	(ng/mL)	q	P value	Pos. (%)	χ2	P value
ANXA2
HCC	115	24.60 ± 7.60			100 (86.96)1
MLC	25	24.22 ± 9.153	0.482	0.803	20 (80.00)3	0.812	0.368
LC	38	16.35 ± 8.863	11.621	< 0.001	12 (31.58)3	44.652	< 0.001
CH	35	6.85 ± 1.563	22.566	< 0.001	0 (0.00)3	91.304	< 0.001
AH	28	6.92 ± 1.413	20.948	< 0.001	0 (0.00)3	80.971	< 0.001
NC	30	6.16 ± 1.273	22.757	< 0.001	0 (0.00)3	84.058	< 0.001
AFP
HCC	115	1446.76 ± 1573.46			81 (70.44)2
MLC	25	1241.76 ± 1349.143	1.087	0.442	12 (48.00)3	4.635	0.031
LC	38	73.73 ± 168.033	7.969	< 0.001	6 (15.79)3	34.771	< 0.001
CH	35	69.05 ± 106.733	6.761	< 0.001	5 (14.29)3	34.583	< 0.001
AH	28	70.54 ± 107.113	7.306	< 0.001	4 (14.29)3	29.446	< 0.001
NC	30	6.06 ± 1.633	7.506	< 0.001	0 (0.00)3	47.874	< 0.001

¹Serum annexin A2 (ANXA2) level > 18 ng/mL or

²Serum α-fetoprotein (AFP) level > 50 ng/mL was abnormal;

³Compared with the hepatocellular carcinoma (HCC) group. MLC: Metastatic liver cancer; LC: Liver cirrhosis; CH: Chronic hepatitis; AH: Acute hepatitis; NC: Normal controls; Pos. (%): Positive case number (%).

Table 3 Pathologic characteristics of annexin A2 expression in sera of 115 hepatocellular carcinoma patients (mean ±SD)

Group		n	(ng/mL)	t	P value	Pos. (%) > 18 ng/mL	χ2	P value
Sex	Male	88	24.56 ± 5.84	0.150	0.881	78 (88.64)	0.933	0.334
	Female	27	24.79 ± 5.33			22 (81.48)
Age (yr)	≥ 50	87	24.84 ± 6.07	0.798	0.427	76 (87.36)	0.050	0.822
	< 50	28	23.83 ± 4.56			24 (85.71)
Tumor size (cm)	≥ 5.0	75	24.38 ± 5.68	0.850	0.397	66 (88.00)	0.207	0.649
	< 5.0	40	25.35 ± 5.95			34 (85.00)
α-fetoprotein (ng/mL)	≥ 400	53	24.91 ± 5.52	0.531	0.596	45 (84.91)	0.365	0.546
	< 400	62	24.34 ± 5.96			55 (88.71)
HBsAg	Positive	79	27.38 ± 5.67	6.820	< 0.001	73 (92.41)	6.605	0.010
	Negative	36	18.58 ± 7.83			27 (75.00)
Differentiated grading	Well	37	20.43 ± 4.97			25 (67.57)
	Moderate	43	26.19 ± 5.34	4.9661	< 0.0011	41 (95.35)	10.6311	0.0011
	Poor	35	27.05 ± 5.13	5.5611	< 0.0011	34 (97.14)	10.6331	0.0011
TNM staging	Stages I-II	52	21.16 ± 5.97			38 (71.43)
	Stages III-IV	63	27.44 ± 6.01	5.5942	< 0.0012	62 (97.06)	16.1222	< 0.0012
Extrahepatic metastasis	With	62	26.11 ± 5.43	3.191	0.002	58 (93.55)	5.514	0.023
	Without	53	22.79 ± 5.64			42 (79.25)
Portal vein thrombus	With	60	26.03 ± 5.99	2.859	0.005	56 (93.33)	4.498	0.034
	Without	55	23.06 ± 5.03			44 (80.00)

¹Compared with the well differentiated group;

²Compared with the tumor node metastasis (TNM) stage I -II group. HBsAg: Surface antigen of the hepatitis B virus; Pos. (%): Positive case number (%).

Table 4 Efficiency evaluation of serum annexin A2 or/and α-fetoprotein levels for hepatocellular carcinoma diagnosis¹

Project of evaluation	ANXA2 (%)	AFP (%)	Both (%)
Sensitivity	86.96	70.43	96.52
Specificity	66.67	73.08	68.67
Accuracy	75.28	71.96	80.07
Positive predictive value	65.79	65.85	68.10
Negative predictive value	87.39	77.03	96.61

¹Serum annexin A2 (ANXA2) level >18 ng/mL or α-fetoprotein (AFP) level > 50 ng/mL was abnormal.