Abstract
Background and study aim: Hepatoma is the most common cancer worldwide, being regarded as the fifth of all malignancies. Mandating for a new, sensitive and specific markers for HCC are critically needed. Human paraoxonase-1 (PON-1), a Ca+2 dependent esterase in the liver, with antioxidant functions, and binds to the HDL particles and hence discarding carcinogenic lipid radicals as byproduct of lipid peroxidation. The aim of this study was to estimate the importance of serum PON-1 activity and concentration in HCC in Egyptian patients as a more sensitive and specific biomarker compared to an established biomarker; Alpha-fetoprotein (AFP). Patients and Methods: This study was conducted on 88 subjects: 64 patients; 40 patients with HCC, 24 cirrhotic patients and 24 healthy subjects who admitted in Internal Medicine Department, Suez CanalUniversityHospital, Ismailia, Egypt. Clinical and radiological investigations in those of the Cirrhotic, and HCC groups for viral hepatitis markers, liver function tests, serum assay of AFP and PON-1 activity and cconcentrations. Results: The results showed that PON-1 concentration was found significantly lower in HCC patients than those of the control and Cirrhotic group (p<0.001).The sensitivity and specificity of PON-1 concentration for HCC were superior to those of AFP and PON-1 activity especially in recently detected HCC. PON-1 concentration had a sensitivity of 88.3% and specificity of 90.48% at the optimal cut-off value of 70.55 (ng/ml). AFP gives a sensitivity of 82.50% and specificity of 73.08 at a cut-off 20.44 ng/ml. Conclusion: This study demonstrates that PON1 concentration and activity were superior to AFP in the recently detected HCC.
Highlights
Hepatoma is the commonest primary liver cancer
The Demographic data of the studied groups: according to the severity of liver disease using Child Classification in the Cirrhotic (LC) and HCC groups, classified as 17.5% of HCC group were child A, 35% were child B and 47.5% were child C compared to 33.3%, 54.2% and 12.5 % in the Liver Cirrhotic (LC) group respectively
HCC patients showed significantly reduced serum PON1 concentration compared with LC and healthy controls (P
Summary
Hepatoma is the commonest primary liver cancer. Major etiologic factors for HCC are longstanding infections with hepatotropic viruses; hepatitis B virus (HBV), hepatitis C virus (HCV), the exposure to aflatoxin-b and excessive alcohol consumption [1].Poor life expectancy in HCC patients with a less than 5% 5-year survival rate. Diagnostic AFP is a marker with poor sensitivity and specificity [2] and the ultrasound is dependent on the experience of the operator [3]. Human serum paraoxonase-1 (PON1) that has lipophilic antioxidant characteristics. By removal of carcinogenic lipid soluble radicals as byproduct of lipid peroxidation. Mandating for a new, sensitive and specific markers for HCC are critically needed. Human paraoxonase-1 (PON-1), a Ca+2 dependent esterase in the liver, with antioxidant functions, and binds to the HDL particles and discarding carcinogenic lipid radicals as byproduct of lipid peroxidation. The aim of this study was to estimate the importance of serum PON-1 activity and concentration in HCC in Egyptian patients as a more sensitive and specific biomarker compared to an established biomarker; Alpha-fetoprotein (AFP)
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