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Abstract
The prognosis of patients with hepatocellular carcinoma(HCC) is generally very poor with a 5-year survival rate of less than 15% since most of them are diagnosed clinically at their late stage. However, the differential diagnosis between alpha fetoprotein(AFP) negative HCC and cirrhotic nodules is still difficult. To evaluate the diagnostic value of glypican-3(GPC3) in patients with AFP negative hepatitis B related HCC. The liver tissue GPC3 (GPC3L) expression was tested from 426 for surgery and 179 of needle biopsies of hepatitis B related HCC patients using immunohistochemistry staining. Serum GPC3 (GPC3S) and AFP were also measured. Among surgical HCC samples, 80.0% of GPC3L expression was positive, however, in paracarcinomatous and cirrhotic nodules were negative. In needle biopsy tissues, GPC3L positively expression was in 74.9%. The sensitivity of AFP>400 µg/L was 25.4%. The GPC3S >3.5 µg/L was determined as a positive. The area of ROC curve of GPC3S was 0.68(95% CI 0.56-0.79,P<0.05) in all HCC patients,0.81 (95% CI 0.62 -0. 98, P<0.05) in AFP greater or equal to 400 µg/L and 0.64 (95% CI 0.51-0.77, P=0.051) in AFP negative patients. The GPC3S was positive in 48.8% of patients with AFP negative. No difference was observed between GPC3L/GPC3S and serum AFP. GPC3 may be helpful in improving diagnosis of HCC and in differentiating diagnosis between AFP negative HCC and cirrhotic nodules.
Highlights
The hepatocellular carcinoma HCC is one of the most common malignant tumor in the world, especially in China, because the main etiological factor of HCC in China is HBV infection[1]
GPC3L positively expression was in 74.9%
GPC3 may be helpful in improving diagnosis of HCC and in differentiating diagnosis between AFP negative HCC and cirrhotic nodules
Summary
The hepatocellular carcinoma HCC is one of the most common malignant tumor in the world, especially in China, because the main etiological factor of HCC in China is HBV infection[1]. Monoclonal antibodies including HepPar-1, cytokeratin 7(CK7), cytokeratin 19(CK19), cytokeratin 20(CK20), thyroid transcription factor-1 (TTF-1, carcinoembryonic antigen (CEA), CD34, alpha fetoprotein (AFP) were usually used to differentiate HCC, cholangiocarcinoma and other metastatic tumors. They are hardly useful to identify hepatic benign or malignant nodules[8,9,10]. The prognosis of patients with hepatocellular carcinoma(HCC) is generally very poor with a 5-year survival rate of less than 15% since most of them are diagnosed clinically at their late stage.,the differential diagnosis between alpha fetoprotein(AFP) negative HCC and cirrhotic nodules is still difficult. Objectives: To evaluate the diagnostic value of glypican-3(GPC3) in patients with AFP negative hepatitis B related HCC
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