Research Paper Volume 12, Issue 19 pp 19455—19467

Cancer-testis antigen lactate dehydrogenase C4 in hepatocellular carcinoma: a promising biomarker for early diagnosis, efficacy evaluation and prognosis prediction

Zhaolei Cui1, , Yun Li2, , Yanni Gao1, , Lingying Kong3, , Yingfeng Lin1, , Yan Chen1, ,

  • 1 Laboratory of Biochemistry and Molecular Biology Research, Fujian Provincial Key Laboratory of Tumor Biotherapy, Department of Clinical Laboratory, Fujian Cancer Hospital and Fujian Medical University Cancer Hospital, Fuzhou 350014, Fujian, PR China
  • 2 Department of Blood Transfusion, The First Hospital of Fujian Medical University, Fuzhou 350009, Fujian, PR China
  • 3 Department of Pathology, Fujian University of Traditional Chinese Medicine Affiliated People’s Hospital, Fuzhou 350004, Fujian, PR China

Received: May 2, 2020       Accepted: June 22, 2020       Published: October 9, 2020
How to Cite

Copyright: © 2020 Cui et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Expressions and clinical implications of cancer-testis antigen (CTA) lactate dehydrogenase (LDH)-C4 in hepatocellular carcinoma (HCC) have not been fully elucidated. Herein, expressions of LDHC mRNA in the serum and serum-derived exosomes of early-stage HCC patients were determined using qRT-PCR, and the expression of LDH-C4 protein in HCC tissues was detected using high-throughput tissue microarray analysis. It was found that positive rates of LDHC mRNA expressions in the serum and serum exosomes of HCC patients were 68% and 60%, respectively. The AUCs of serum and exosomal LDHC in differentiating HCC patients from healthy controls were 0.8382 and 0.9451, respectively. The serum and exosomal LDHC levels in HCC patients in the treatment group were higher than the levels in the preliminary diagnosis group, but lower than those in the recurrence group. Survival analysis showed that the expression of LDH-C4 was negatively correlated with the prognosis of HCC. The Cox regression analysis showed that an LDH-C4 level was an independent risk factor for the prognosis of HCC patients. Therefore, serum and exosomal LDHC can be used as a biomarker for early diagnosis, efficacy evaluation and recurrence prediction of HCC. Moreover, LDH-C4 can be used as an important reference indicator for monitoring the prognosis of HCC.


AFP: alpha fetoprotein; AJCC: American Joint Committee on Cancer; CEA: carcino-embryonic antigen; CA19-9: glycoprotein antigen 199; CTA: cancer-testis antigen; EV: extracellular vesicle; GP-73: Golgi protein 73; HCC: hepatocellular carcinoma; HRP: horseradish peroxidase; IHC: immunohistochemical; LDH-C4: lactate dehydrogenase C4; OS: overall survival; PIVKA-II: Protein Induced by Vitamin K Absence or Antagonist-II; qRT-PCR: real-time quantitative reverse transcription PCR; RCC: renal cell carcinoma; SD: standard deviation; TEM: transmission electron microscope; UICC: Union for International Cancer Control.