Diagnostic Value of Serum CHI3L1 in Hepatocellular Carcinoma Explored

Primary liver cancer is the sixth diagnosed cancer and the fourth cause of cancer-related death worldwide. Hepatocellular carcinoma (HCC) is the major pathological category and comprises a 75%–85% incidence of primary liver cancer cases.

Chitinase 3-like protein 1 (CHI3L1) belongs to the family 18-glycosyl hydrolase but lacks chitinolytic activity. CHI3L1 has shown better performance in diagnosing liver fibrosis than other noninvasive methods in chronic hepatitis B patients.


Scientists specializing in Hepatology at the University of Chinese Academy of Sciences (Ningbo, China) enrolled in a retrospective study the following: matched age and gender subjects, 40 patients with liver cirrhosis, 40 patients with chronic hepatitis, and 40 healthy subjects were enrolled in the control group. The data was collected from December 2018 to April 2020. The serum CHI3L1 level was determined by enzyme-linked immunosorbent assay (ELISA) and in a blinded manner.

The CHI3L1 ELISA Kit was produced by Proprium Biotech Company Limited, (Hangzhou, China). The expression level of CHI3L1 was detected once the subjects first visit the clinic or admit to hospital. The follow-up time was 8 to 22 months. During the follow-up period, laboratory monitoring was performed every 3 to 6 months, including routine blood chemistry tests and imaging studies using computed tomography (CT) or magnetic resonance imaging (MRI) to monitor disease status. The clinicopathological data of 50 paired HCC and adjacent non-tumor tissues as well as 278 unpaired HCC tissues, and the relative expression levels of CHI3L1 was studied.

The investigators reported that the median serum level of CHI3L1 in the HCC group was 168.84 ng/mL (95%CI = 96.24, 322.61 ng/mL), which was significantly higher than the median serum level of CHI3L1 in the control group, median = 71.36 ng/mL (95% CI = 48.63, 114.77 ng/mL). Serum CHI3L1 level was closely correlated with serum α-fetoprotein (AFP) level, tumor-node-metastasis (TNM) stage, Child-Pugh stage, the maximum diameter of tumor, and presence of liver cirrhosis, but there was no significant correlation between gender and age.

The patients with high AFP level (>400 ng/L), TNM III + IV stage, large tumor diameter, liver cirrhosis, and Child-Pugh B + C had higher serum CHI3L1 levels. The overall survival (OS) rate of patients with high expression of CHI3L1 was significantly lower than that of patients with low expression of CHI3L1. Combining the serum CHI3L1 and α-fetoprotein (AFP) by a binary logistic regression model can increase the diagnostic sensitivity to 97.5%. Multivariate Cox regression analysis indicated that CHI3L1 is an independent prognostic factor in patients with HCC.

The authors concluded that they compared the difference of serum CHI3L1 between the HCC group and the control group, analyzed the diagnostic performance of CHI3L1 for HCC, and evaluated the prognostic power of serum CHI3L1 in HCC patients. The results showed that serum CHI3L1 can help to increase diagnostic power and evaluate prognosis for HCC patients. The study was published on January 16, 2022 in the Journal of Clinical Laboratory Analysis.

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