Case Control Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Jul 27, 2025; 17(7): 108850
Published online Jul 27, 2025. doi: 10.4254/wjh.v17.i7.108850
Evaluating serum extra spindle pole bodies-like 1 protein vs p53 antibody for hepatitis B virus-related hepatocellular carcinoma diagnosis
Yan-Fei Feng, Hui-Kun Zhou, Bo-Bin Hu, Hang Wang, Heng-Kai Liang, Lu Wei, Qing-Mei Li, Tu-Mei Su, Qian-Bing Yin, Ming-Hua Su, Jian-Ning Jiang
Yan-Fei Feng, Hui-Kun Zhou, Bo-Bin Hu, Hang Wang, Heng-Kai Liang, Lu Wei, Qing-Mei Li, Tu-Mei Su, Qian-Bing Yin, Ming-Hua Su, Jian-Ning Jiang, Department of Infectious Diseases, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
Jian-Ning Jiang, Guangxi Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor, Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
Jian-Ning Jiang, Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor (Guangxi Medical University), Ministry of Education, Nanning 530021, Guangxi Zhuang Autonomous Region, China
Co-first authors: Yan-Fei Feng and Hui-Kun Zhou.
Co-corresponding authors: Ming-Hua Su and Jian-Ning Jiang.
Author contributions: Feng YF and Zhou HK contributed equally to this work; Su MH and Jiang JN have made crucial and indispensable contributions towards the completion of the project and thus qualified as co-corresponding authors; Feng YF, Zhou HK, Hu BB, Wang H, Liang HK, Wei L, Li QM, Su TM, and Yin QB performed the research and analyzed the data; Feng YF and Zhou HK analyzed the data and wrote the manuscript; Su MH and Jiang JN designed and supervised the study; All authors read and approved the final version.
Supported by National Natural Science Foundation of China, No. 81960115, No. 82160123 and No. 82260124; Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor (Guangxi Medical University), Ministry of Education, No. GKE-ZZ202107; Guangxi Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor, No. GKE-ZZ202218; and Guangxi Science and Technology Program, No. AD25069077.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board of the First Affiliated Hospital of Guangxi Medical University (Approval No. 2025-E0320).
Informed consent statement: Consent was not obtained but the presented data are anonymized and risk of identification is low.
Conflict-of-interest statement: There are no conflicts of interest to disclose.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Data sharing statement: No additional data are available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jian-Ning Jiang, MD, PhD, Chief Physician, Professor, Department of Infectious Diseases, The First Affiliated Hospital of Guangxi Medical University, No. 6 Shuangyong Road, Nanning 530021, Guangxi Zhuang Autonomous Region, China. gxjjianning@163.com
Received: April 25, 2025
Revised: May 31, 2025
Accepted: June 25, 2025
Published online: July 27, 2025
Processing time: 92 Days and 1.6 Hours
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.

Keywords: Extra spindle pole bodies-like 1; p53 antibody; Hepatocellular carcinoma; Hepatitis B virus; Diagnostic biomarker; Case-control study

Core Tip: This study evaluates serum extra spindle pole bodies-like 1 (ESPL1) protein as a diagnostic biomarker for hepatitis B virus-related hepatocellular carcinoma (HBV-HCC), demonstrating superior sensitivity and accuracy compared to p53 antibody and alpha-fetoprotein (AFP). ESPL1 levels progressively increase from chronic hepatitis B to cirrhosis and HCC, correlating with disease progression. Mechanistically, ESPL1 overexpression due to HBV integration drives chromosomal instability, promoting oncogenesis. These findings support ESPL1 as a promising biomarker for early HBV-HCC detection. The study also suggests that ESPL1 may complement AFP in clinical settings, offering enhanced diagnostic reliability and supporting its potential as a novel candidate for HBV-HCC early detection.