MicroRNA hepatocellular carcinoma detect: discriminant function based on a circulating panel of microRNA for accurate diagnosis of hepatocellular carcinoma patients on top hepatitis C virus infection

BACKGROUND: Hepatocellular carcinoma (HCC) is a major complication of chronic hepatitis C virus (HCV) infection, and its early diagnosis is limited by the suboptimal performance of α-fetoprotein. Circulating microRNAs (miRNAs) have emerged as promising noninvasive biomarkers for detecting malignant transformation in high-risk patients. This study evaluated the diagnostic value of serum miRNA-141.3p, miRNA-155, miRNA-106b, and miRNA-423 in distinguishing HCC from liver cirrhosis among HCV-infected individuals and developed a combined miRNA-based predictive score. METHODS: A total of 145 participants were included: 42 patients with HCV-related HCC, 83 cirrhotic HCV patients without malignancy, and 20 healthy controls. Serum miRNA levels were quantified. Diagnostic performance was assessed by receiver operating characteristic curve analysis, and multivariate discriminant analysis was used to construct a composite index, termed the miR-HCC Detect score. RESULTS: All four miRNAs were significantly upregulated in cirrhosis and HCC compared with healthy controls ( P < 0.05), with the highest expression observed in HCC. Individually, miRNA-155 and miRNA-141.3p demonstrated strong diagnostic accuracy for differentiating HCC from controls [area under the curve (AUC) = 0.988 and 0.924, respectively], while miRNA-106b and miRNA-423 showed moderate discrimination between HCC and cirrhosis. The miR-HCC Detect score achieved an AUC of 0.824, with 96% sensitivity and 62% specificity at a cutoff value of 0.44, and clearly differentiated cirrhosis from HCC (0.63 ± 0.16 vs. 5.1 ± 1.67; P < 0.001). CONCLUSION: These circulating miRNAs represent promising noninvasive biomarkers for HCC detection in HCV-infected patients. The miR-HCC Detect score outperforms individual miRNAs and may improve early HCC surveillance.