Serum ESPL1 Protein as an Early Warning Biomarker for the Initial Occurrence and Recurrence of Hepatitis B Virus-Related Hepatocellular Carcinoma

Abstract Aim This study aims to assess the potential of serum Extra Spindle Pole Bodies-like 1 (ESPL1) protein as a biomarker for the effective early warning of Hepatitis B Virus (HBV)-related hepatocellular carcinoma (HCC). Methods A cross-sectional study was conducted, including 119 patients who were classified into three groups: chronic hepatitis B (CHB), HBV-related liver cirrhosis (LC), and HBV-HCC. Additionally, a longitudinal study included 49 patients in a non-recurrent (N-Rec) group with first occurrence of HBV-HCC and a recurrent (Rec) group with multiple HCC recurrences. Serum ESPL1 levels were measured using enzyme-linked immunosorbent assay. Differences in serum ESPL1 levels among the CHB, HBV-LC, and HBV-HCC groups and alpha-fetoprotein (AFP) levels among these groups were compared. The dynamic changes of serum ESPL1 and AFP levels were analyzed in the N-Rec group before and after the hepatectomy and in the Rec group before and after each HCC recurrence. Results Serum ESPL1 levels showed a gradual increase in the CHB, HBV-LC, and HBV-HCC groups ( P <0.05). In the N-Rec group, serum ESPL1 levels exhibited a continuous upward trend in the 5 years before the hepatectomy, followed by a consistent decline over the subsequent 5 years. In the Rec group, serum ESPL1 levels demonstrated a fluctuating pattern of increase and decrease before and after each liver cancer resection. Conversely, the changes in serum AFP levels did not follow a consistent pattern. Conclusion Serum ESPL1 has potential as a biomarker for effective early warning of initial and recurrent HBV-related HCC.