AFP In Diagnosis Research Articles

The chemokine CCL20 can assist AFP in serological diagnosis of hepatocellular carcinoma

The chemokine 20 (CCL20) is a member of the CC chemokine family and plays a role in tumor immunity and autoimmune disease. This work investigated the value of CCL20 as a serum diagnostic marker for primary hepatocellular carcinoma (HCC). Based on the data of hepatocellular carcinoma patients in the TCGA database, the up-regulated genes encoding secretory proteins were analyzed in each pathological stage, and the candidate marker CCL20 gene was selected. Serum concentrations of CCL20 in patients with primary HCC, benign liver disease, and healthy subjects were analyzed by enzyme-linked immunosorbent assay (ELISA). The ROC curve evaluated the efficacy of CCL20 alone or in combination with AFP in the diagnosis of HCC. It was found the expression of CCL20 in HCC patients was significantly higher than that in the benign liver disease group and healthy controls (P < 0.05); The AUC of ROC curve to distinguish HCC patients from healthy controls was 0.859, the sensitivity was 73.42%, and the specificity was 86.84%. After combination with AFP, the AUC increased to 0.968, the sensitivity was 88.16%, and the specificity was 97.37%. Although CCL20 was increased in the serum of patients with benign liver diseases, combined with AFP, the AUC to distinguish HCC patients from non-HCC cohorts (benign liver disease group and healthy control group) was 0.902, with a sensitivity of 91.67% and a specificity of 75.26%. Collectively, serum CCL20 is closely related to the occurrence of HCC, and detection of serum CCL20 can assist AFP in improving the diagnostic sensitivity of HCC.

Vitronectin (VTN): A Novel Diagnostic and Prognostic Marker for Hepatocellular Carcinoma (HCC) On Top Of Chronic Hepatitis C Virus Related Diseases

Abstract Background Hepatocellular carcinoma (HCC) is the fifth most common cancer worldwide and the most common form of primary liver cancer. Aim of the study to study the level of serum vitronectin (VTN) compared to AFP in diagnosis and prognosis of hepatocellular carcinoma on top of HCV-related liver diseases. Patients and Methods This prospective observational study included a total number of 60 subjects who were divided into 4 groups: Group 1: include 10 normal persons. Group 2: included 10 patients who have Hepatitis C Virus infection. Group 3: included 20 cirrhotic patients. Group 4: included 20 patients with HCC (on top of hepatitis C virus related cirrhosis), in which we tested them for vitronectin before first intervention and after intervention within 3 months. Results The mean age of the cases showed high statistically significant difference between the study groups (P &amp;lt; 0.001).There were a total number of 29 males and 31 females with significant difference in the sex distribution between the study groups. 80% of the cases in HCC group were males. This sex distribution can be attributed to high prevalence of risk factors like smoking, DM and HCV in males in addition to possible role of sex hormones. On analyzing laboratory characters of the studied groups, we found statistically significant difference between cirrhosis group and non-cirrhotic groups with low platelets count, high serum creatinine, high INR, lower serum albumin, high bilirubin and higher AST. The median level of AFP in group 4 (HCC patients) was 110 IU/ml which was higher than its median value in the other study groups with high level of significance between the study groups. The median level of vitronectin levels in the different study groups didn’t reveal a statistically significant difference between the different study groups. Serum level of vitronectin in group 3 (cirrhotic patients) has no statistically significant difference between the three subgroups according to child's classification. By the analysis of serum level of AFP and vitronectin level in group IV (HCC patients) before and after treatment, the median level of AFP was significantly lower than its level before intervention, while the decrease in vitronectin level was statistically insignificant after intervention. Conclusions Chronic HCV infection and its serious complicatons specially HCC are still representing a health challenge in Egypt, reflecting wide HCV prevalence and late diagnosis. Serum AFP alone has an unreliable role in HCC surveillance as it has low sensitivity because it may be normal in up to 40% of HCC cases especially early stages of the tumor, and low specificity as its levels may be elevated in conditions other than HCC as cirrhosis or exacerbation of chronic hepatitis or even in some cases of cholangiocarcinoma. AFP is useful in clinical practice in screening and diagnosis of HCC in association with US and CT. According to our study, we can't use Vitronectin alone in diagnosis and prognosis of HCC on top of cirrhosis related to HCV +ve infection. It didn’t reveal a statistically significant difference between the different study groups ,so it may require further study and research.

Value of Plasma Squamous Cell Carcinoma Antigen-IgM Immune Complexes (SCCA-IgM IC) as a Novel Biomarker for Monitoring Hepatocellular Carcinoma Treatment Outcome

Abstract Background Assessment of the levels of Squamous Cell Carcinoma Antigen-IgM Immune Complexes (SCCA-IgM IC) as a serum biomarker to assess the prognosis and treatment outcome of HCC after locoregional treatment Aim of the work Evaluation of plasma squamous cell carcinoma antigen-IgM immune complex (SCCA-IgM IC) level as a biomarker to predict response to treatment with radiofrequency ablation (RF) and/or trance arterial chemoembolization (TACE) in HCC patients. Patients and Methods This study was conducted at the Internal Medicine department, Faculty of Medicine, Ain Shams University, during the period from July 2016 to November 2018 on 60 sequentially recruited patients with HCC undergoing locoregional treatment (RF and/or TACE). Patients were divided into two groups, Group A: 40 patients underwent TACE, Group B: 20 patients Underwent RF, all patients were followed up at 3 and 6 months post treatment. Patients who were excluded, those with HCC with late stage of the BCLC (Barcelona clinic liver cancer) staging system, patients with decompensated liver disease (Child-Pugh C), Hepato-renal syndrome or renal insufficiency, patients who had history of organ transplant or previously treated HCC. Results SCCA IgM IC serum level was significantly lower in patients without recurrence post TACE than patients with HCC recurrence at 3 and 6 months post treatment. SCCA IgM IC showed promising results especially when combining with AFP in diagnosis and monitoring of treatment response of HCC Conclusion the use of SCCA IgM IC in combination with AFP serum level may prove to be useful in assessing prognosis of HCC locoregional treatment

Evaluating the diagnostic value of serum Des-γ carboxy prothrombin in the detection of hepatocellular carcinoma

Hepatocellular carcinoma (HCC) is amongst the most common cancers in the world and Vietnam. Most HCC patients are diagnosed late, so the effect of treatment is limited. Hence, early diagnosis for high-risk populations using medical imaging and serum markers is very important to control HCC. Recently, α-fetoprotein (AFP) has been popularly used as a serum marker for screening of HCC. Unfortunately, AFP is not trustworthy enough for HCC diagnosis, especially early HCC. Therefore, this study was deployed to estimate the ability of serum Des-γ carboxy prothrombin (DCP) applied in the diagnosis of HCC. DCP and AFP concentration in serum of 50 early HCC patients (stage A), 50 late HCC patients (stage B and C), 50 HBV/HCV-infected patients, and 50 healthy persons were identified. ROC curve analysis manifested that with the cut-off value at 11.93 ng/ml, DCP allowed identifying HCC cases with the sensitivity and specificity of 50 and 94%, respectively. With early HCC, the sensitivity of DCP decreased to 34%, while the specificity was unchanged. In the case of AFP, results showed that the sensitivity and specificity of this marker for HCC were 39 and 95%, with the cut-off value at 952.1 ng/ml. For early HCC, it was impossible to use AFP for diagnosis. The combination of DCP and AFP serum markers in the detection of HCC did not improve the sensitivity of the diagnosis compared to that of DCP alone. The study demonstrated that serum biomarker DCP can be used instead of AFP in the diagnosis of HCC, which improves the diagnostic sensitivity

Utility of combined biomarkers PIVKA-II and AFP in diagnosis of liver carcinoma in context of liver disease

Utility of combined biomarkers PIVKA-II and AFP in diagnosis of liver carcinoma in context of liver disease

Reply to Letter to the Editor: Mean Platelet Volume may not be A Diagnostic Marker for Hepatocellular Carcinoma due to Chronic Hepatitis C Infection

We would like to thank Beyan and Beyan for their interest in our article and for their comments on this article. They stated that mean platelet volume (MPV) can be affected by many factors including time of analysis after venipuncture, methods of analysis, anticoagulant used and specimen storage temperature . I do agree that there should be more details for this part in our study, but all MPV values were measured in dipotassium EDITA tubes within 1st hour after venipuncture, there was no different approach in MPV measurement between our patients and controls therefore, we don't believe this factor significantly influenced our results. It's true that MPV is affected by age and sex in some studies and not in other studies as prof/ Beyan and prof/ Beyan mentioned in their comments, but we adjust the age and sex mismatch in our study by using logistic analysis and found that MPV still independent predictor for HCC. In our study, MPV was less sensitive and less specific than AFP in diagnosis of HCC. So in conclusion MPV can be studied as an added marker for AFP to increase its specificity and sensitivity in diagnosis of HCC. However it can't be replace the role of AFP in diagnosis. Further studies are needed in this area.

Significance of Glypican-3 in Early Detection of Hepatocellular Carcinoma in Cirrhotic Patients

Egypt has high incidence of hepatocellular carcinoma (HCC). This is due to wide spread of hepatitis C virus (HCV) infection which is responsible for most of the cases of liver cirrhosis. The major diagnostic techniques for HCC include serum markers and various imaging modalities. Glypican 3 (GPC3) protein is highly expressed in HCC, but not in normal liver tissue. The significance of GPC3 as a predictor or diagnostic tool for human tumors other than HCC is unclear. To quantitatively assess the role of GPC3 in diagnosis of HCC in comparison to α-fetoprotein (AFP), ultrasonography (US), and computerized tomography (CT). This cross-sectional study enrolled 85 subjects: 40 cirrhotic patients with primary HCC, 30 cirrhotic patients without HCC, and 15 healthy individuals. All patients were recruited from the Gastroenterology and Tropical Departments and outpatient clinics of New Damietta Hospital during the period from November 2010 to August 2012. GPC3 is positive in some HCC patients with normal levels of AFP. AFP has lower sensitivity (67.5%) compared to higher sensitivity of GPC3 (82.5%), and near specificity (61.2%) to GPC3 (57.8%). The combined serum AFP and GPC3 significantly increased the sensitivity of HCC diagnosis. Although GPC3 is better than AFP in diagnosis of HCC, it still lacks the 100% sensitivity and specificity because some patients have negative or normal level of GPC3 (below the cutoff point 1.5ng/ml) despite being diagnosed by triphasic CT.

Mean Platelet Volume and Mean Platelet Volume/Platelet Count Ratio as Diagnostic Markers for Hepatocellular Carcinoma in Chronic Hepatitis C Patients

Background and study aim: Hepatocellular carcinoma (HCC) is the most common primary malignant tumor of the liver. AFP is the gold standard tumor marker for HCC, mean platelet volume (MPV) is a parameter obtained from complete blood count (CBC) by automated analyzers, shown to be increased in multiple malignancies and inflammatory conditions.This prospective study was designed to evaluate the diagnostic usefulness of MPV and MPV/ platelet count (PC) ratio in HCC patients due to chronic hepatitis C (CHC) infection. Materials and Methods: One hundred and twenty subjects enrolled in this study, they were divided into 4 equal groups: group I included 30 healthy subjects (control group), group II included 30 patients with chronic viral hepatitis without cirrhosis, group III included 30 cirrhotic patients without HCC and group IV included 30 cirrhotic patients with HCC.MPV, MPV/PC ratio & AFP were evaluated in all groups. Triphasic CT was done for patients of group IV to confirm the diagnosis of HCC. Liver biopsy was done for patients of group II to confirm the diagnosis of chronic hepatitis C. Results: MPV showed higher levels in HCC group compared to control, CHC, and cirrhotic groups with p value(<0.001) but there was no statistically significant difference between HCC group and cirrhotic group (p value=0.49), while MPV/platelet count ratio was higher in cirrhotic group (0.19±0.09 fL/ 109/L) than HCC group (0.14±0.08 fL/109/L) but also with no significant differences between both groups (p=0.06). There was insignificant positive correlation between MPV and AFP in HCC group ( Session [CurrentTestPartTermID];= 0.11 and p value =0.57). Also, there was insignificant negative correlation between MPV/PC and AFP in HCC group ( Session [CurrentTestPartTermID];= -0.17 and p value =0.37). In receiver operating characteristic (ROC) curve analysis, MPV had high sensitivity (73.33%), specificity (70 %), and area under curve (AUC) was 0.7, So it more better than MPV/platelet count ratio in diagnosis of HCC which had sensitivity (76.67%), low specificity (56.67%), and AUC was 0.63, while AFP had much higher sensitivity (90%), specificity (98.33%) than both studied parameters (MPV, MPV/PC ratio) with highly statistically difference when compared to MPV (p<0.001) and area under curve (AUC) was 0.9. Conclusion: MPV and MPV/PC ratio are less sensitive and specific than AFP in diagnosis of HCC. So AFP is still the gold standard marker in diagnosis of HCC and MPV and MPV/PC ratio may be used only in association with other markers like AFP to improve sensitivity of tumor detection.

Dickkopf-1 and hepatocellular carcinoma

e410 www.thelancet.com/oncology Vol 13 October 2012 evidence exists to suggest that DKK1 was better than AFP for diagnosis of hepatocellular carcinoma of 5 cm or smaller. Finally, Shen and colleagues did not assess hepatocellular carcinoma related to hepatitis C virus infection, heavy alcohol consumption, cholangio carcinoma, or metastatic cancer. More studies are needed before DKK1 can be accepted as a diagnostic tool for hepatocellular carcinoma.

Advancement in researches of typical marker of AFP for diagnosis and treatment of liver cancer

虽然仍被认为足肝细胞癌(HCC)诊断中的经典标志物,在肝癌诊治有了长足进展的今天,甲胎蛋白(AFP)也不再是单纯的诊断指标.更不是惟一指标,它在肝癌的癌变机制、分子和基因诊断、肝癌的生物导向治疗、以及与多种方法的结合等多方面,具有重要价值.现就AFP用于肝癌诊治研究中的近年进展综述如下。

Clinical application of avidin-biotin ELISA to detect serum hepatoma-specific gamma-glutamyltransferase in patients with primary hepatic cancer

To detect serum hepatoma-specific datura stramonium lectin-tightly binding gamma-glutamyl transferase (DSA-GGT) in patients with primary hepatic cancer (PHC) by avidin-biotin ELISA method which was established in our laboratory, and carry on a study of its clinical application. To detect serum DSA-GGT in 45 healthy control subjects, 58 PHC patients and 203 non-PHC patients (including 36 patients with other tumors and 167 patients with benign liver diseases) with the method was established; meanwhile, AFP was detected by ELISA method. 38 individuals were DSA-GGT positive in 58 PHC patients, the sensitivity was 65.5%. 18 individuals were DSA-GGT positive in 203 patients without PHC, the specificity was 91.1%. The sensitivity and specificity of AFP in diagnosis of PHC patients was 69.0% and 90.6%, respectively. The sensitivity and specificity of combination of DSA-GGT and AFP was 93.1% and 85.7%, respectively. The average intra-CV and inter-CV of DSA-GGT ELISA was 8.9% and 11.5%, respectively. The sensitivity and specificity of DSA-GGT ELISA method established in our lab is similar with that of AFP assay and the accuracy is good. Combination of DSA-GGT and AFP may improve the diagnostic sensitivity. The method should be potentially as a new way to improve diagnosis of PHC.

Clinical Value of Serum CEA, CA 19-9, CA 242 and AFP in Diagnosis of Gastrointestinal Tract Cancers

Clinical Value of Serum CEA, CA 19-9, CA 242 and AFP in Diagnosis of Gastrointestinal Tract Cancers