Assessment of the Value of Mean Plathlet Volume, Des Gamma Carboxy Prothrombin and Alpha Feto Protein in Early Detection of HCC

Abstract

Abstract Background Primary liver cancer is the sixth most commonly diagnosed cancer and the fourth leading cause of cancer mortality worldwide, with an estimated 841,000 cases (9.3 cases per 100,000 person-years) and 782,000 deaths (8.5 deaths per 100,000 person-years) in 2018. HCC being often associated with liver cirrhosis masks symptoms of cancer progression and thus the clinical course of HCC is mostly asymptomatic. Aim of the Work To determine the value of mean platelet volume, Des gamma Carboxy prothrombin and Alfa-feto protein in early detection of Hepatocelluler carcinoma Patients and Methods This case cross sectional comparative study had been carried out after the approval of the Ethics Committees of the faculty of medicine Ain Shams university on 105 subjects, age range 25-68 year selected from: Patients attending Hepatology and virology outpatient clinic at ElDemerdash hospital Also Liver transplantation center at Ain Shams specialized hospital in Cairo after informed consent were taken from the patients Results In this study HCC was found to be more prevalent in men 28 (80.0%) than in women 7 (20.0%). In our study AFP, MPV and DCP were highest in HCC group, followed by CLD group and lowest in control group. The differences between all groups were significant in MPV and DCP, with no significant difference between CLD and HCC in AFP. In the present study, DCP values of HCC group showed a highly significant increase upon comparison with the non malignant groups (II, and III). The sensitivity of DCP was higher than AFP in detecting HCC patients (97.1% versus 54.3%), Conclusion Measurement of MPV is non-invasive, cheap and quick, and may therefore serve as a predictor of HCC in patients with CLD. Low sensitivity and specificity, on the other hand, suggests that this may be an adjunctive parameter to some other markers like AFP. Further studies with larger samples are needed to determine the association of MPV with HCC. For a single test DCP had highest significant diagnostic performance in differentiating HCC from CLD groups. In detection of HCC testing AFP≥ 40.0 if positive considered positive. If negative, retest for DCP≥ 69.3 if positive considered positive, otherwise is negative. This although deceased specificity and Positive predictive value, it raised sensitivity and Negative Predictive Value to 100.0% when combining both AFP and DCP.