Serum Thioredoxin Level for Assessment of Response after Ablation Therapy for Hepatocellular Carcinoma in Egyptian Patients

Background: Hepatocellular Carcinoma (HCC) is a major health problem worldwide and its diagnosis is still challenging. Thioredoxin (TRX) is a class of small redox proteins known to be present in all organisms. It plays a role in many important biological processes, including redox signaling. Aims: The main aim of this study was to study the serum thioredoxin level for assessment of response after ablation therapy for hepatocellular carcinoma in Egyptian patients. Patients and Methods: This prospective case study was carried out in Department of Tropical Medicine and Infectious Diseases, Tanta University Hospital. The duration of study was from April 2019 till April 2020.  Results: Significant differences were found between the four groups regarding TRX as group B and C showed significant elevation in TRX level compared to group A & D. TRX was significantly decreased after 6 months compared to 3 months and preoperative. TRX at cutoff 100 ng/ml can differentiate between early HCC and liver cirrhosis with the sensitivity, specificity, PPV and NPV was 95%, 85%, 86% and 94% respectively.  There were positive significant correlations between TRX and focal lesion size. There were also positive significant correlations between TRX and aspartate transaminase (AST), Total bilirubin, direct bilirubin and international normalization ratio (INR). In group C after therapeutic intervention, there was a significant decrease in TRX level among patients showing complete response compared to those with partial response or progressive course. Conclusions: TRX could serve as a potential diagnostic biomarker for HCC. TRX could be used as a predictive marker of therapeutic ablation outcome in hepatocellular carcinoma patients.