Detection of MAGE-4 Protein Sera of Patients with Liver Cirrhosis a useful maker for prediction of hepatocellular carcinoma

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The majority of hepatocellular carcinomas (HCC) in Japan are caused from liver cirrhosis (LC) patients who have long suffered with hepatitis virus infection. Development of a useful serum marker for prediction of HCC is needed for better treatment and care of these patients. We previously reported that the MAGE-4 protein in sera of both HCC and LC patients were significantly higher than those of the control.This study has addressed whether level of MAGE-4 protein is useful for prediction of HCC by measurement of the serum MAGE-4 protein in LC (n=61) patients as a control at least 3 different times within 8 years. HCC was observed in 28 (46%) of these LC patients during this period, respectively. MAGE-4 protein was positive (>1.15 ng/ml) in 14 of 28 HCC patients (50%) before the diagnosis of LICC. And MAGE-4 protein was positive in only 3 of 33 LC patients (9%) who were not diagnosed as HCC. Levels of MAGE-4 protein in 7 or 5 patients were positive one or two year before the time of diagnosis of HCC, respectively. MAGE-4 protein decreased after the treatment of HCC in all the 6 patients tested, and became negative in 4 patients.We then performed the uni-valiated analysis of the predicting risk factors of HCC : gender, age, scrum AST, AFP value and MAGE-4 in 28 patients diagnosed as HCC. AFP level (over 20 ng/ml) (p=0.02) and MAGE-4 protein level (p=0.01) were significant as a factor for prediction of HCC.The multi-variated analysis was also performed. The MAGE-4 protein level in sera was the most significant risk factor for the prediction (p = 0.002).Thus, level of serum MAGE-4 was better that the any other serum markers tested for prediction of HCC in LC patients.Measurement of serum MAGE-4 could be a novel tool for prediction of HCC in LC patients.