Comparison between multiple serum biomarkers in diagnosis of hepatocellular carcinoma in egyptian patients

Abstract

Background: Hepatocellular carcinoma (HCC) is the most well-known essential primary tumor of the liver. It is the second leading cause of cancer-related deaths worldwide, with a very poor prognosis. Early diagnosis and effective treatment of HCC remain a challenging in worldwide. If detected very early, HCC can be cured with an excellent long-term prognosis. HCC frequently develops in the setting of underlying chronic liver disease. Viral hepatitis (infection with either hepatitis C virus [HCV] or hepatitis B virus [HBV]) is thought to be the most common etiology of HCC where estimated 78% of global HCC cases. As markers of HCC occurrence are still very scare and early detection of HCC increases the chance of treatment. Analysis of late researches demonstrated that AFP assessment lacks satisfactory sensitivity and specificity for good surveillance and diagnosis. As early detection of HCC is essential, new markers with enough sensitivity and specificity are needed. Aim: This work aims to compare between serum level of AFL-3, ICAM-1, HGF 19 and SCCA levels as diagnostic markers for HCC. Patients and Methods: The present study was conducted on a total number of 180 subjects divided in to 3 groups: 60 healthy individuals as control group,60 patients with liver cirrhosis and without any evidence of HCC as LC group and 60 patients with HCC as HCC group. Patients with cancers other than HCC or metastatic liver cancer were excluded. Clinical data were collected from patients file. Alpha Fetoprotein (AFP), AFL-3, ICAM-1, HGF, SCCA levels, serum HBsAg and anti-HCV were determined using ELISA method. Abdominal ultrasound scan was also done. Results: The four biomarkers (AFP-L3, ICAM-1, HGF19 & SCCA) plus AFP were elevated in HCC in comparison with LC patients and in both HCC and LC groups in comparison with control group. Conclusion Three of our serum biomarkers (SCCA, HGF19 and AFP-L3) were better than the golden standard serum AFP in both sensitivity and specificity. Serum level of ICAM-1had a higher specificity but lower sensitivity in comparison with AFP serum level.