Serum thioredoxin is a diagnostic marker for hepatocellular carcinoma

Here we found that serum levels of thioredoxin were increased in patients with hepatocellular carcinoma (HCC). The optimum diagnostic cutoff for thioredoxin was 20.5 ng/mL (area under curve [AUC] 0.946 [95% CI 0.923–0.969] in the training cohort; 0.941 [0.918–0.963] in the validation cohort). High serum concentrations of thioredoxin differentiated HCC from chronic liver diseases and cirrhosis (0.901 [0.875–0.923] in the training cohort; 0.906 [0.870–0.925] in the validation cohort). Furthermore, a higher proportion of patients with very early HCC had positive results for thioredoxin than for alpha-Fetoprotein (AFP) (73.7% VS.31.6%; P < 0.0001). Among AFP-negative patients with very early HCC, 18 (69.2%) of 26 had positive thioredoxin results. Our results indicate that serum thioredoxin complements measurement of AFP in the diagnosis of HCC, especially in very early disease. Combined model (thioredoxin and AFP) showed a significantly greater discriminatory ability as compared with those markers alone.