Acylcarnitine: Useful biomarker for early diagnosis of hepatocellular carcinoma in non-steatohepatitis patients

Figure 1 Differences in carnitine, tumor markers, and angiogenic factors between non-steatohepatitis patients with and without hepatocellular carcinoma. A: Level of AFP; B: Level of DCP; C: Level of AFP-L3%; D: Level of VEGF; E: Level of VEGFR-2; F: Level of total carnitine; G: Level of free carnitine; H: Level of acylcarnitine. The level of acylcarnitine (H) was significantly lower in non-SH patients with HCC vs that observed in non-SH patients without HCC (P < 0.05). In addition, the level of AFP-L3% (C) was significantly higher in non-SH patients with HCC compared with that reported in non-SH patients without HCC (P < 0.05). However, the levels of AFP, DCP, VEGF, VEGFR-2, total carnitine, and free carnitine (A, B, D, E, F, and G) were not different between the two groups of patients. SH: Steatohepatitis; HCC: Hepatocellular carcinoma; AFP: α-Fetoprotein; DCP: Des-γ-carboxy prothrombin; AFP-L3%: Lens culinaris agglutinin-reactive α-fetoprotein; VEGF: Vascular endothelial growth factor; VEGFR-2: VEGF receptor-2.

Figure 2 Diagnostic accuracy of acylcarnitine for the early diagnosis of hepatocellular carcinoma in non-steatohepatitis patients. ROC analysis of acylcarnitine revealed that the cutoff value was 5.088, the specificity was 89.5%, the sensitivity was 92.9%, and the AUC was 0.925.

Figure 3 Acetylcarnitine is associated with vascular endothelial growth factor and hepatocellular carcinoma progression in non-steatohepatitis patients. A: ROC analysis of acetylcarnitine (AC2) for the early diagnosis of hepatocellular carcinoma (HCC) in non-steatohepatitis patients revealed that the cutoff value was 3.18, the specificity was 84.2%, the sensitivity was 100%, and the AUC was 0.925; B: The patients were categorized into two groups according to the ROC cutoff vale for AC2 (low, < 3.18; and high, ≥ 3.18). The patients with AC2 < 3.18 had a significantly higher level of vascular endothelial growth factor (VEGF) compared with those with AC2 ≥ 3.18. The patients with HCC were categorized into two groups according to the median cutoff value for total tumor volume (low, < 6.3 and high, ≥ 6.3); C: The HCC patients with a total tumor volume of ≥ 6.3 had a significantly higher VEGF/AC2 ratio compared with those with a total tumor volume of < 6.3. AC2: acetylcarnitine; VEGF: vascular endothelial growth factor.