Heat Shock Protein 47 as a Novel Predictive and Diagnostic Biomarker for Thrombosis in Hepatocellular Carcinoma

Thrombosis is a severe complication in hepatocellular carcinoma (HCC), significantly contributing to poor prognosis. Emerging evidence suggests that elevated heat shock protein 47 (HSP47) is closely associated with hypercoagulable states, indicating its potential role as a key mediator in thrombotic processes. This study aimed to evaluate the predictive and diagnostic value of plasma HSP47 levels for thrombosis in HCC patients.

We collected plasma samples from 169 patients with HCC, 114 with liver cirrhosis (LC), and 91 healthy controls (HC). Plasma HSP47 levels were compared across these groups and relevant subgroups. Logistic regression analysis identified independent risk factors for thrombosis in HCC. Receiver operating characteristic (ROC) curve analysis assessed the diagnostic performance of HSP47 and D-dimer.

Plasma HSP47 levels were significantly higher in the HCC group compared to both the LC and HC groups (P < 0.001). This elevation was more pronounced in patients with hypercoagulability (D-dimer > 0.5 mg/L) or active thrombosis. Multivariate analysis confirmed HSP47 as an independent risk factor for thrombosis. The ROC curve for HSP47 yielded an area under the curve (AUC) of 0.859 (95% CI: 0.780-0.939), with a sensitivity of 81.5% and specificity of 82.4%, outperforming D-dimer (AUC = 0.740, 95% CI: 0.640-0.840; P < 0.05).

Our findings identified HSP47 as an independent risk factor for thrombosis in HCC patients and demonstrated its strong potential as a diagnostic biomarker. This study provided a new theoretical foundation for the early diagnosis of HCC-associated thrombosis, offering a promising target for clinical translation. It should be noted that this was a single-center retrospective study, and further prospective multicenter validation is warranted to enhance the generalizability of the findings.