Abstract
The rate of hepatocellular carcinoma (HCC) is increasing worldwide including Egypt. Non-B non-C HCC was reported in some countries. We aimed to investigate P53 antibodies and alpha-fetoprotein in patients with non-B non-C HCC in our region. In a case series study, included 281 patients with HCC and 20 patients with liver cirrhosis of matched age, sex and social factors were received for management at Tanta University Hospitals. Sera were tested for HCV and HBV markers by ELISA/PCR, alpha-fetoprotein (AFP) level and anti-p53 antibody were evaluated by ELISA. Antinuclear antibody, serum copper and iron were assessed in non-viral HCC. Liver scanning and biopsy were evaluated. Non-B non-C HCC patients were 13.87% of total. P53 antibody serum level in non-B non-C HCC patients showed insignificant difference (p>0.05) as compared to viral-associated HCC, while significant as compared to cirrhosis. They had significant decrease in serum AFP level (p<0.001) as compared to viral-associated HCC. Their tumors were mainly solitary, and have smaller-sizes. Sensitivity, specificity, PPV, NPV and accuracy test of anti P53 antibody positive patients were 91.52%, 84.63%, 90.34%, 80.2% and 74.8% respectively. It correlates positively with AFP, tumor size and staging, MELD score and Child-Pugh score.Non-B non-C HCC showed high serum prevalence of anti-p53 as viral-associated HCC suggesting an evidence of high onchogenecity. It appears of much benefit in diagnosis, follow up and differentiation from cirrhosis in presence of low levels of alpha-fetoprotein.
Highlights
There is a heterogeneous distribution of hepatocellular carcinoma (HCC) at regional and international levels due to infectious and/or environmental factors that may contribute to risk (Lehman et al 2007)
Clinical assessment and diagnosis of HCC was based on detection of hepatic focal lesions by imaging techniques plus serum alpha-fetoprotein (Sorin Biomedica - 3rd generation ELISA) and guided liver & tumor biopsy for histopathological confirmation
Serum total iron binding capacity, ceruloplasmin, and antinuclear antibody were detected in average values in non-B non-C HCC patients
Summary
There is a heterogeneous distribution of HCC at regional and international levels due to infectious and/or environmental factors that may contribute to risk (Lehman et al 2007). Egypt has the highest prevalence of HCV worldwide and has rising rates of HCC (Lehman and Wilson 2009). The major risk factors include chronic HBV and HCV infections and chemical exposures (Wang et al 2002, and Ertle et al 2010). The proportion of non-B non-C HCC has been increasing in many areas of the world (Ertle et al 2010). The pattern of HCC and its risk factors is changing (Anwar et al 2008). The p53 protein is involved in DNA repair and is an oncoprotective antigen.
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