Abstract
Background: hepatitis C is an inflammatory liver disease caused by the hepatitis C infection (HCV), and without treatment, almost 50% will progress to liver cirrhosis. Hepatocellular carcinoma (HCC) is the most frequent type of primary liver cancer and the fourth leading cause of cancer-related mortality. Aim of the study: the objective of this study was to evaluate the serum level of vitronectin (VTN) compared to AFP and determine their role as diagnostic and prognostic markers of HCV-related liver diseases. Subject and Methods: this study involved 52 HCV patients from which 26 patients were cirrhotic, and 26 patients had HCC (on top of hepatitis C virus-related cirrhosis) plus 10 healthy people as a control group. It was carried out in Gastroenterology and Hepatology Unit, Internal Medicine Department, Zagazig University Hospitals, Egypt. All individuals in this study were subjected to physical examination, full history taking, liver function tests, assessment of serum levels of Vitronectin (VTN) and alpha-fetoprotein (AFP) before and after the intervention within three months. Results: serum level of vitronectin increased significantly in cirrhosis patients and HCC patients than controls (p = 0.0041), (p < 0.001), respectively, and in HCC than cirrhosis patients (p < 0.001). Significant positive correlations were observed between levels of serum VTN and AFP in all HCV patients as well as cirrhotic patients (p < 0.001, p = 0.011, respectively). On the contrary, VTN and AFP didn’t show a significant correlation in HCC patients’ group. Moreover, the median serum level of VTN decreased significantly after treatment in patients with HCC (p < 0.001). At cut-off 38.5 ng/mL for AFP it shows sensitivity 80.8%, specificity 76.9% to differentiate HCC from cirrhosis cases. While VTN shows 84.6% sensitivity, 96.2% specificity at cut-off 26.5 μg/mL. Regarding clinicopathological characteristics and VTN levels, half of patients were stage B, 63.9% had tumor size >3 cm, 84.6% had more than one focal lesion. Conclusions: these results may allow one to speculate a potential role of Vitronectin in diagnosis and prognosis of HCC on top of cirrhosis related to HCV infection in addition to AFP and US and CT.
Highlights
Hepatitis C virus (HCV), an RNA virus from the Flaviviridae family, causes hepatitis C, inflammatory liver disease, which can be transmitted through blood and without treatment almost 50% will progress to liver cirrhosis which may develop Hepatocellular carcinoma (HCC) [1]
Most cases of HCC are combined with cirrhosis caused by chronic infection with hepatitis B virus (HBV) or hepatitis C virus (HCV), so they should be enrolled into surveillance programs using ultrasound and serum α-fetoprotein (AFP) [3]
DiVsicturossnieocntin is a secreted acute-phase glycoprotein present in serum and extracellular matriVx itthraotnsetcimtinuliastaesseccerlleateddhaesciuotne-apnhdaseprgelaydcionpgrothteroinupghreisnetnetrainctisoenrus mwiathndinetxegtrraincesl.luItlaisr pmriamtraixriltyhagtesnteimrauteladtebsycheellpaadtohceystieosn[a1n5]d. spreading through interactions with integrins. It is prIimt iasriilnycgreeanseerdateind hbyephaetpoacetollcuyltaers ([H15C].C) patients especially in those with adverse prognIot sistiicnfcarcetaosresd[1in6]h. epatocellular (HCC) patients especially in those with adverse prognostiIcnftahcitsorress[e1a6rc].h, the median value of AFP level in HCC patients’ group was 89.5 IU/mL which was higher than its median value in the other study groups with high level of significance between the study groups (p < 0.001). This agreed with Yang et al [17] who revealed that serum AFP level in patients with HCC was significantly higher than those of liver cirrhosis and chronic hepatitis patients and apparently healthy controls
Summary
Hepatitis C virus (HCV), an RNA virus from the Flaviviridae family, causes hepatitis C, inflammatory liver disease, which can be transmitted through blood and without treatment almost 50% will progress to liver cirrhosis which may develop HCC [1].Hepatocellular carcinoma (HCC) is the most frequent form of primary liver cancer and the fourth most prevalent cause of cancer-related mortality [2].Most cases of HCC are combined with cirrhosis caused by chronic infection with hepatitis B virus (HBV) or hepatitis C virus (HCV), so they should be enrolled into surveillance programs using ultrasound and serum α-fetoprotein (AFP) [3].Direct-acting antivirals (DAA) are highly effective for the treatment of chronic hepatitis C virus (HCV) infection. Hepatitis C virus (HCV), an RNA virus from the Flaviviridae family, causes hepatitis C, inflammatory liver disease, which can be transmitted through blood and without treatment almost 50% will progress to liver cirrhosis which may develop HCC [1]. Hepatocellular carcinoma (HCC) is the most frequent form of primary liver cancer and the fourth most prevalent cause of cancer-related mortality [2]. Most cases of HCC are combined with cirrhosis caused by chronic infection with hepatitis B virus (HBV) or hepatitis C virus (HCV), so they should be enrolled into surveillance programs using ultrasound and serum α-fetoprotein (AFP) [3]. The goal of antiviral therapy is to reduce transmission and prevent the consequences of chronic HCV infection including cirrhosis, hepatocellular carcinoma (HCC), and death [5]
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