sCD36 as a Biomarker for Progression and Recurrence in Type 2 Diabetes Mellitus Associated Hepatocellular Carcinoma.

Background: To evaluate the relationship between soluble CD36 (sCD36) and type 2 diabetes mellitus complicated by hepatocellular carcinoma (T2DM-HCC), and to explore its potential clinical prognostic value. Methods: A prospective study was conducted enrolling newly diagnosed T2DM-HCC patients from two medical centers, along with control groups including healthy individuals (HC), T2DM patients, and HCC patients. Clinical, biochemical, and pathological data were collected. Serum sCD36 levels were measured by ELISA. Univariate and multivariate analyses were used to identify recurrence risk factors, and ROC analysis was performed to evaluate diagnostic performance. Results: Among 258 participants, the T2DM-HCC group exhibited the highest sCD36 levels, impaired liver function, lower platelets, and mild chronic inflammation. In this group, sCD36 levels positively correlated with tumor stage, size, and proliferation. In univariable analysis, it was associated with postoperative recurrence (OR = 2.57, 95% CI: 0.68-9.67). The predictive ability of sCD36 for recurrence (AUC = 0.86) was comparable to AFP (AUC = 0.89), while their combination showed the highest accuracy (AUC = 0.94). Conclusion: sCD36 is associated with tumor progression in T2DM-HCC patients and serves as an independent risk factor for recurrence. To the best of our knowledge, this is the first study to identify sCD36 as a critical clinical biomarker for disease progression in T2DM-HCC, with strong potential for clinical application. Trial Registration: This study was registered in September 2024 with the Chinese Clinical Trial Registry (ChiCTR), registration number: ChiCTR2400089651.