Serum Expression Levels of miR-141 and miR-215 for Differentiation between Liver Cirrhosis, Chronic Hepatitis C and Hepatocellular Carcinoma Patients

Objectives: To evaluate the ability of estimation of serum expression levels of micro RNA (miR-141 and miR-215 to differentiate between liver cirrhosis, chronic hepatitis C (CHC) and hepatocellular carcinoma (HCC) patients.

Patients and Methods: The study included 25 liver cirrhosis patients, 25 CHC patients, 25 HCC patients and 15 volunteers (Control group). All patients underwent clinical examination, preliminary investigations and radiological workup. Fasting blood samples were withdrawn from all patients and controls for estimation of serum levels of α-fetoprotein (AFP), quantitative PCR estimation of HCV RNA titers and real-time PCR quantitation of serum expression levels of miR-215 and miR-215 -141.

Results: Serum AFP levels were significantly higher in HCC patients than cirrhosis and CHC patients. Estimated serum expression levels of miR-215 were significantly higher in CHC and HCC patients compared to both controls and cirrhosis, while serum expression levels of miR-141 were significantly lower in HCC patients compared to controls and cirrhosis patients and in CHC patients than controls. Estimated HCV viral load in CHC patients showed positive significant correlation with serum expression level of miR-215, while showed non-significant correlation with miR-141. Estimated serum levels of miR-215 and miR-141 could differentiate hepatic patients and controls with AUC= 0.872 and 0.250, respectively. Whereas, estimated serum levels of miR-215 could differentiate between cirrhosis and CHC patients with AUC= 0.899. Estimated serum levels of miR-215 and miR-141 also could be used to identify HCC patients out of hepatic disease patients with AUC of 0.818 and 0.351, respectively.

Conclusion: Serum expression levels of miR-215 and miR-141 could be used to identify hepatic disease patients with high positive predictive value (PPV) especially miR-215. miR-215 can differentiate between cirrhosis and CHC patients and correlated with HCV load. Serum levels of both miRs could assure diagnosis of HCC with high PPV.