Expression of hnRNPK & Claudin-4 in HCV-Induced Early HCC and Adjacent Liver Tissue

BACKGROUND: HCC in Egypt usually occurs in HCV cirrhotic livers with poor prognosis due to late diagnosis. High hnRNPK & low Claudin-4 profiles indicate Epithelial Mesenchymal Transition (EMT), malignant transformation and high-grade tumours.AIM: We studied the immunohistochemical expression of hnRNPK and Claudin-4 in HCV induced early HCC (eHCC) and adjacent liver tissue in Egyptian patients to improve eHCC detection in cirrhotic livers with better curative therapy options.METHOD: We studied the immunohistochemical expression of hnRNPK and Claudin-4 in 100 Egyptian patients resection specimens of HCV induced early HCC (eHCC) and adjacent liver tissue, in order to improve eHCC detection in cirrhotic livers, thus improving their therapeutic options.RESULTS: Early HCC grade significantly directly correlated with nuclear hnRNPK/5HPFs count and inversely correlated with Claudin-4 expression %, with a converse correlation between hnRNPK and Claudin-4. Moreover in eHCC, combined hnRNPK ³ 30/5HPFs & Claudin-4 ³ 40% significantly distinguished low grade eHCC (G1) from high grade eHCC (G2&G3), with sensitivity 97% & specificity 69.7% for hnRNPK ³ 30/5HPFs, and with sensitivity 70% & specificity 94.3% for Claudin-4 ³ 40%. Moreover in the adjacent liver, both markers expressions significantly directly correlated with each other and with METAVIR fibrosis score but not with activity. Furthermore, 58% of eHCCs showed hnRNPK ³ 30 Claudin-4 < 40% profile, indicating EMT type3, compared to 26% with hnRNPK ³ 30 Claudin-4 £ 10% profile in adjacent cirrhotic/ precirrhotic liver, with significant use of combined hnRNPK ³30/5HPFs & Claudin 4 £ 10% as eHCC prediction cut offs in cirrhosis (p < 0.05).CONCLUSION: Combination of hnRNPK and Claudin-4 can indicate early HCC development in HCV cirrhotic livers using hnRNPK ³ 30/5HPFs & Claudin-4 £ 10% cut offs. Also, combination of hnRNPK ³ 30/5HPFs & Claudin-4 ³ 40% can distinguish low grade eHCC (G1) from high grade eHCC (G2&G3)