Abstract
Background and Aim: Early diagnosis of hepatocellular carcinoma (HCC) is essential for achieving good prognosis. Glypican 3 (GPC3) has been reported to be raised in HCC in comparison with non-neoplastic lesions. This work aimed to study the role of GPC3 in the early diagnosis of HCC in post-chronic hepatitis C (CHC) cirrhotic patients. Patients and Methods: A comparative study included 60 patients, 40 patients with HCC (HCC group) and 20 patients of CHC without HCC (control group). Diagnosis of HCC was based on abdominal ultrasound and triphasic CT, while biopsy was performed in debating cases. Serum samples for measurement of GPC3 and AFP levels were obtained from all participants. Results: The median levels of both AFP and GPC3 were significantly higher among HCC cases compared to controls. Analysis of the ROC curve showed that both AFP and GPC3 could be used to differentiate HCC cases from controls. AUROCs of GPC3 and AFP were 0.928 and 0.727 respectively, and both were statistically significant with p-values < 0.0001. The best cut-off value for GPC3 for HCC detection was 3.15 ng/ml with 82% sensitivity (95%CI: 67 - 93) and 95% specificity (95%CI: 75 - 99), and for AFP it was 257 ng/ml with 77% sensitivity (95%CI: 61 - 89) and 85% specificity (95%CI: 62 - 97). Conclusion: Serum GLP-3 is highly sensitive and specific for detecting HCC, more than AFP for the early detection of HCC, and the combination of both yielded improved sensitivity.
Highlights
Hepatocellular carcinoma (HCC) is one of the most common cancers and represents the third most common cause of death worldwide [1] [2] [3]
Diagnosis of hepatocellular carcinoma (HCC) was based on abdominal ultrasound and triphasic computed tomography (CT), while biopsy was performed in debating cases
In ROC curve analysis, Glypican 3 (GPC3) was an excellent HCC predictor with AUROC of 0.928 (p < 0.001), while Alpha fetoprotein (AFP) was an average predictor with AUROC of 0.727 (p < 0.001), Figure 1 and Table 2
Summary
Hepatocellular carcinoma (HCC) is one of the most common cancers and represents the third most common cause of death worldwide [1] [2] [3]. Diagnosis of hepatocellular carcinoma (HCC) is essential for achieving good prognosis. This work aimed to study the role of GPC3 in the early diagnosis of HCC in post-chronic hepatitis C (CHC) cirrhotic patients. Results: The median levels of both AFP and GPC3 were significantly higher among HCC cases compared to controls. Analysis of the ROC curve showed that both AFP and GPC3 could be used to differentiate HCC cases from controls. The best cut-off value for GPC3 for HCC detection was 3.15 ng/ml with 82% sensitivity (95%CI: 67 - 93) and 95% specificity (95%CI: 75 - 99), and for AFP it was 257 ng/ml with 77% sensitivity (95%CI: - 89) and 85% specificity (95%CI: - 97). Conclusion: Serum GLP-3 is highly sensitive and specific for detecting HCC, more than AFP for the early detection of HCC, and the combination of both yielded improved sensitivity
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