STUDY OF DES-GAMMA-CARBOXYPROTHROMBIN (DCP) LEVELS IN CHRONIC HEPATITIS C WITH OR WITHOUT HEPATOCELLULAR CARCINOMA (HCC) IN EGYPTIAN PATIENTS

Omnia Kamel

doi:10.21608/ajps.2015.12528

Abstract

Hepatocellular carcinoma (HCC) is usually asymptomatic in the early stage and does not show elevated alpha-feto protein (AFP). Des-Gamma-CarboxyProthrombin (DCP) and Carbohydrate antigen 19-9 (CA19-9) may increase in sera of HCC patients. The ultimate goal is to evaluate the potential role of DCP and CA19-9 compared to AFP as early diagnostic, non-invasive markers for chronic hepatitis C patients with and without HCC. 26 chronic HCV patients, 26 HCC related to HCV and 25 normal controls were studied. Quantitative determination of AFP, DCP and CA19-9 concentrations in sera was done using commercially available Enzyme-linked Immunosorbent Assay (ELISA) kits. Results: In HCC patients, AFP showed the highest diagnostic accuracy (90.2%) followed by DCP (80.4%) and CA19-9 (70.6%). AFP showed the highest specificity and sensitivity (100%-80.8%). DCP and CA19-9 showed the same specificity (92%) but DCP showed higher sensitivity (69.2%) than CA19-9 (50%). In HCV patients, CA19-9 showed the highest diagnostic accuracy (74.5%) followed by DCP (70.6%). AFP showed the lowest diagnostic accuracy (58.8%).Both CA19-9 and DCP showed highest specificity (100%), AFP is the lowest (84%). CA19-9 showed the highest sensitivity (50%), followed by DCP (42.3%) and AFP (34.6%). Significant higher levels of DCP and CA-19-9 were detected in HCC patients with low AFP levels (P<0.05).Conclusion: Serum levels of DCP and CA19-9 could be used as sensitive tumor markers to detect HCV patients with HCC and also to detect HCV patients who are at risk to develop cancer.

Highlights

Four percent of the world’s population are chronically infected with HCV and as many as 30% of it will develop cirrhosis within 20 years of infection and a large subset will subsequently develop liver failure and/or hepatocellular carcinoma (Bostan and Mahmood, 2010)
It is reasonable that any noxa which is able to promote tissue inflammatory damage and, sequentially, reparative features with fibrotic tissue deposition and parenchymal regeneration can induce CA19.9 synthesis (Schöniger-Hekele and Müller, 2006).The present study investigates the potential role of serum DCP and Carbohydrate antigen 19-9 (CA19-9) compared to alpha-feto protein (AFP) as early diagnostic, non-invasive markers in chronic HCV patients with and without Hepatocellular carcinoma (HCC)
It was found that 8(30.8%) of HCC patients and 100% of both chronic HCV and normal controls had AFP levels < 200 ng/ml

Summary

Introduction

Four percent of the world’s population are chronically infected with HCV and as many as 30% of it will develop cirrhosis within 20 years of infection and a large subset will subsequently develop liver failure and/or hepatocellular carcinoma (Bostan and Mahmood, 2010). RESULTS: The mean concentrations of serum AFP, DCP and CA19-9 were determined in 26 patients with HCC related to HCV, 26 patients with HCV without HCC and 25 normal controls.

Results

Conclusion