Elevated Serum ITGBL1 mRNA Expression: A Promising Diagnostic Tool for HBV-Associated Hepatocellular Carcinoma

Abstract

Background: Hepatocellular carcinoma (HCC) accounts for 75 - 85% of primary liver cancers and is characterized by poor prognosis and low five-year survival rates, particularly in advanced stages. Chronic hepatitis B virus (HBV) infection is a major risk factor for HCC. Early detection of HBV-related HCC is crucial for improving patient outcomes; however, current surveillance methods such as ultrasonography and serum alpha-fetoprotein (AFP) testing have limited sensitivity. Objectives: This study aimed to evaluate serum mRNA expression of the biomarker integrin beta-like 1 (ITGBL1) in patients with HBV-related HCC, comparing it to patients with HBV infection only, HCC only, and healthy controls. Methods: In this cross-sectional case-control study, serum samples from 161 individuals (40 with HBV infection, 41 with HCC, 40 with early-stage HBV-related HCC, and 40 healthy controls) were analyzed. The ITGBL1 mRNA levels were quantified using quantitative real-time polymerase chain reaction (qRT-PCR), normalized to GAPDH. Clinical and biochemical parameters were also recorded and analyzed. Data were analyzed using SPSS version 20; analysis of variance (ANOVA) was used for group comparisons, with P < 0.05 considered significant. Results: The ITGBL1 mRNA expression was significantly elevated in the HBV-related HCC group compared to the HBV-only, HCC-only, and control groups (P < 0.01). Increased ITGBL1 expression was also observed in the HCC and HBV groups compared to controls (P < 0.05). Receiver operating characteristic (ROC) analysis showed excellent diagnostic performance for distinguishing HBV-related HCC from controls [area under the curve (AUC) = 0.82, sensitivity = 64.3%, specificity = 90.4%]. The biomarker demonstrated high diagnostic potential for differentiating HBV-related HCC from other groups. Clinical parameters, such as AFP levels, were markedly higher in the HCC and HBV-related HCC groups. No significant differences in age or gender distribution were found among the groups. Conclusions: This study highlights a strong association between ITGBL1 expression and HBV-related HCC, suggesting that serum ITGBL1 mRNA could serve as a sensitive and noninvasive biomarker for early diagnosis of HCC in HBV-infected patients. Its simplicity and reliability in serum samples make ITGBL1 a promising tool for monitoring patients at risk and improving early detection strategies. Limitations include the small sample size and a focus on early-stage HCC.