Introduction: Hepatocellular carcinoma (HCC) is one of the most common cancers in the world and unless diagnosed timely has limited options for treatment. Paraoxonase (PON) is a glycosylated protein that has been implicated in antioxidant and other biochemical functions. Paraoxonase 1 (PON1) is an esterase associated with high-density lipoprotein (HDL) particles. The present study was carried out to assess the PON1 activity and compare it with the standard liver function tests (LFTs) in assessing the predictability of liver damage among patients diagnosed with HCC.

Methods: This case-control study was carried out in the Department of Biochemistry attached to Great Eastern Medical School and Hospital, Srikakulam, Andhra Pradesh. Serum PON1 activities and LFTs like total bilirubin, direct bilirubin, alanine transaminase (ALT), aspartate transaminase (AST), alkaline phosphatase (ALP), total protein, and albumin were estimated in 30 patients diagnosed with HCC and 30 healthy persons. All the parameters were estimated using standard biochemical methods. The data was analyzed using GraphPad Prism version 6.0 (GraphPad Software, Inc). A probability (p) value <0.05 was considered to be statistically significant. Receiver operating characteristic curve (ROC) analysis was performed to assess the area under the curve (AUC) for accuracy, sensitivity, specificity, and diagnostic efficiency.

Results: The serum activities of PON1 had identical sensitivity (70%) to albumin (70%) and were superior to other tested parameters. Additionally, PON1 activities showed lower specificity (86.67%) than the other tested parameters.ROC analysis showed increased diagnostic efficacy (DE) of PON1 (DE=78.3%; p<0.0001) when compared with total bilirubin (DE=76.6%; p=0.0039), direct bilirubin (DE=74.9%; p=0.04), ALT (DE=73.30%; p=0.0006), and total protein (DE=71.6%; p=0.0005). However, the DE of PON1 was comparable with AST (DE=81.60%; p<0.0001), ALP (DE=79.9%; p<0.0001), and albumin (DE=83.30%, p<0.0001).

B. Jyotchna Devi, is an accomplished Biochemist, earned her medical degree from SVS Medical College and furthered her education at Osmania Medical College. Currently serving as an Associate Professor at Great Eastern Medical School and Hospital. With keen focus on Serum paraoxonase, she has authored four impactful research articles, showcasing her expertise. Beyond her research activity, she actively contributes to the Medical Education Unit (MEU), embodying her commitment to nurturing the next generation of medical professionals. Currently pursuing the Advanced Course in Medical Education (ACME) at JIPMER in Puducherry exemplifying her dedication to continuous learning and innovation.