Combination Of AFP Research Articles

Tumor Markers in Differential Diagnosis of Benign Ovarian Masses.

Although there are many benign tumors in the ovarian adnexal area, the four most common types are still luteal cyst, ovarian mature cystic teratoma (OMCT), ovarian endometriosis, and benign epithelial tumors of the ovary. This study aimed to examine the correlation between six tumor markers (CEA, AFP, CA125, CA19-9, SCC, HE4) in the differential diagnosis of female adnexal benign masses and assess their diagnostic value. In this study, 135 patients with adnexal benign masses were treated in Zhengzhou first people's Hospital from January 2018 to January 2023. 135 patients were divided into four groups: luteal cyst (13.3%), OMCT (42.2%), ovarian endometriosis (23.7%) and benign epithelial tumors of the ovary (including mucinous cystadenoma and serous cystadenoma) in group D. The receiver-operating characteristic (ROC) curve was used to assess the diagnostic value of each marker and combined detection. The diameter of luteal cysts was significantly smaller than that of benign ovarian tumors (p < 0.001). ROC analysis showed that the combination of AFP, CA125, CA19-9, and SCC had a higher diagnostic rate for luteal cysts (AUC=0.871; sensitivity: 71.8%; specificity: 88.9). The SCC level in OMCT was significantly higher than in other benign ovarian tumors (p=0.007). ROC analysis indicated that the combination of AFP, HE4, and SCC had a higher diagnostic rate for OMCT (AUC=0.753; sensitivity: 65.4%; specificity: 75.4%). The CA125 level in ovarian endometriosis was significantly higher than in other accessory benign tumors (p < 0.001). ROC analysis demonstrated that the combination of AFP, CA125, and CA19-9 had a higher diagnostic rate for ovarian endometriosis (AUC=0.935; sensitivity: 76.7%; specificity: 96.9%). The tumor diameter of benign epithelial tumors of the ovary was significantly larger than that of other benign ovarian tumors (p < 0.001). ROC analysis revealed that the combination of CA125 and CA19-9 had a higher diagnostic rate for benign epithelial tumors of the ovary (AUC=0.792; sensitivity: 64.5%; specificity: 85.7%). The findings of this study demonstrate that the combined use of tumor markers (CEA, AFP, CA125, CA19-9, SCC, and HE4) has value in diagnosing benign ovarian tumors, including luteal cysts, OMCT, ovarian endometriosis, and benign epithelial tumors of the ovary. However, it is important to acknowledge the limitations of this study, which include its single-center nature and the small sample size. Despite these limitations, the results highlight the potential utility of these markers in clinical practice.

Wireless Sensor Technology-Based Physical Education Teaching Evaluation.

A wireless sensor network (WSN) is a group of geographically scattered and specialized sensors to monitor and record variables related to environmental and storing the obtained data in a vital location. These networks have applications and can be utilized in different research domains including physical education where error prediction is assumed as one of the core issues. Thus, careful attention is required from the researcher to provide reliable and accurate prediction models. Thus, aiming the shortage of large prediction error in the physical education evaluation, which is based on the BP neural network and wireless sensor technology, a combination of AFP and questionnaire survey method is proposed in order to improve the accuracy and predictability of evaluation, according to the characteristics of different evaluation subjects. We select the evaluation index system as the input of wireless sensor technology and then use the principle of genetic algorithm to select the optimal individual and optimize the initial parameters of wireless sensor technology to establish the evaluation model of physical education quality. Through the training and testing of sample data, it is shown that the model greatly improves the accuracy of physical education quality evaluation and has a good application prospect in physical education evaluation.

Diagnostic Value of hTERT mRNA and in Combination With AFP, AFP-L3%, Des-γ-carboxyprothrombin for Screening of Hepatocellular Carcinoma in Liver Cirrhosis Patients HBV or HCV-Related.

Diagnosis of hepatocellular carcinoma (HCC) in early-stage, to give an effective treatment option and improve quality of life for cancer patients, is an important medical mission globally. Combination of AFP with some biomarkers may be more supportive in both diagnosis and screening of HCC, but the range value of these markers can be applied as daily markers were unclearly. In some studies, human telomerase reverse transcriptase (hTERT mRNA) was reported as an advantage marker to diagnose cancer. The present study identified serum of 340 patients that were infected chronic hepatitis B virus or hepatitis C virus and divided in 2 groups including Hepatocellular carcinoma (HCC) and liver cirrhosis (LC) to measure their values of hTERT mRNA, AFP, AFP-L3%, and DCP, as well as combination of them. As a result, the concentration of hTERT mRNA, AFP, AFP-L3%, and DCP in HCC groups were significantly higher than that in LC group (P < .01). For detecting HCC, hTERT mRNA had sensitivity of 88% and specificity of 96% (at the cutoff value of 31.5 copies/mL), AFP sensitivity of 73% and specificity of 92% (at the cutoff value of 5.1 ng/mL), AFP-L3% sensitivity of 69% and specificity of 90% (at the cutoff value of 1.05%), DCP sensitivity of 82% and specificity of 92% (at the cutoff value of 29.01 mAU/mL). The largest area under the curve (AUC) of combination hTERT mRNA with DCP was 0.932 (sensitivity of 98.2% and specificity of 88.2%). New combination of DCP with hTERT mRNA gave a useful choice for screening of HCC in chronic HBV or HCV patients associated liver cirrhosis.

Influence of Automated Fiber Placement Parameters on Thermoplastic Composite Blanks Used on Stamp Forming Process

In recent years, advanced manufacturing processes have been developed to increase the speed of production in order to reduce production costs. At the scale of thermoplastic composites, the translation is the combination of advanced manufacturing processes. The focus in this study is more specifically on the coupling of automated lay-up (AFP) and stamp forming processes. To date, a consolidation process, such as press-consolidation of thermoplastic composites, obtained blanks. Several trials have begun using an automated fiber placement consolidation to reduce manufacturing time and use unidirectional material. However, the combination of AFP and stamp forming is useful if it optimizes this process without the blank’s full consolidation, which by resulting reduces the manufacturing time. This study estimates blank characteristics through thermal history imposed by a more rapid manufacturing process. A set of blanks with varying process parameters is produced to investigate the influence at the microscopic scale. The interface behaviour is observed with optical microscope and image processing. A statistical study applied to the process is carried out in order to relate the material observations to the input parameters. The results of this study are used for the study of the next process of the combination: the stamp forming.

Prognosis of first-line tumor directed therapy for hepatocellular carcinoma using a combination of AFP, AFP-L3, and DCP

Presenter: Paul Thevenot PhD | Ochsner Health System Background: The expanded biomarker panel consisting of α-fetoprotein (AFP), AFP-L3%, and des-γ-carboxy prothrombin (DCP) has improved surveillance and early detection of hepatocellular carcinoma (HCC). The biomarkers individually, when elevated, have also been linked to aggressive tumor biology including vascular invasion and advanced staging. With increased clinical utilization on the horizon, we investigated the role of using biomarker combinations at the time of diagnosis and correlating the outcomes at the time of liver transplantation. Methods: This prospective study was conducted at a single-center in HCC patients presenting to a multi-disciplinary tumor board for liver-directed therapy (LDT) and evaluation for bridge to liver transplantation (8/30/16 – 10/16/20). AFP, AFP-L3%, and DCP were assayed on the day of first line LDT using the μTASWako i30 instrument. Additional analyzed parameters were also obtained prior to first-line LDT and monitored for bridge to transplant outcome as the primary study endpoint. Results: Consented for analysis were 140 treatment naïve HCC patients undergoing first line LDT with transarterial chemoembolization, Ytrrium-90, or microwave ablation. The median cohort age was 61 years with majority demographics of male (74%) and hepatitis C etiology (59%). Tumor burden was 82% within Milan with a median MELD-Na prioritization score of 11. Study endpoint breakdown was 29% transplanted, 29% dropout due to tumor progression, 24% censored from study endpoint, and 18% remaining waitlist active at the time of analysis. Median biomarker values were 10 ng/mL AFP, 7% AFP-L3, and 3.1 ng/mL DCP. Forty-four percent of cohort was negative for all three biomarkers while 14% were triple positive. Univariate analysis for each biomarker at threshold were associated with tumor progression (OR 5.6 – AFP > 20 ng/mL, 4.8 – AFP-L3 >10%, 8.8 – DCP >7.5 ng/mL). Analysis of cohort based on biomarker status (triple negative, AFP only, or positive for AFP-L3% and/or DCP) revealed an association between biomarker positivity and largest lesion size (P < 0.001). Univariate analysis showed largest lesion, and each individual biomarker, along with 2 positive biomarkers was associated with bridge to transplant survival. Controlling for tumor burden in separate multivariate analyses, AFP (HR 4.8), and DCP (HR 2.2), or having 2 positive biomarkers (HR 6.0) remained associated with bridge to transplant survival. In endpoint analysis, patients with more than 2 positive biomarkers had significant lower bridge to transplant survival. Biomarker positivity was also associated with response to first line LDT (OR 3.2). Conclusion: The expanded biomarker panel (AFP, AFP-L3%, and DCP) prior to LDT in bridge to transplant HCC can identify patients at high risk of tumor progression following LDT. The expanded biomarker panel may provide an opportunity to optimize treatment modality with outcome based on profile independent of radiographic tumor burden.

Impact of intervention strategies after failed Mitraclip therapy on mid-term outcome

Abstract Introduction Procedural failure after MitraClip (MC) therapy has a decisive prognostic influence and Re-treatment after acute procedure failure (APF) remains complex due to the generally high-risk patients. The aim of this work is to analyze the mid-term outcome between the surgical and the percutaneous interventional treatment routes according to APF from our High Volume Center. Methods Retrospective analysis of patients (pts.) consecutively treated with MC in the period from 9/2009 - 5/2019 with residual mitral regurgitation (rMR) that is still higher in the case of symptomatic APF (NYHA 3–4). Outcome analysis in primary (PMR) and secondary MR (SMR) with subsequent percutaneous (group Reclip) vs. surgical treatment (group surgery). Results Of a total of 824 pts., 63 (73±10 years, 20 women [31,7%]) showed APF (MR&amp;gt;2) peri / postinterventionally. Mitraclip reintervention was performed in 36 pts. (26 SMR, 10 PMR), while 27 (13 SMR, 14 PMR) underwent surgery. Mitral valve replacement (MVR) was surgically performed on 21 pts. (11 PMR, 10 SMR), while reconstruction (MVrec) was performed on n=6 (3 PMR, 3 SMR). The mechanism of the rMR in the surgery group, n=14 (51.9%) was a pure sail injury (LT) or a partial clip detachment (PCD) or a combination of both, n=9 (33.3%) a severe rMI, n=3 (11.1%) device endocarditis and n=1 (3.7%) a technical device problem. In the reclip group n=15 (41.7%) showed an LT and / or a PCD and n=21 (58.3%) a severe rMR. Thirty-day mortality was 13.9% (n=5 deaths) in the ReClip-group (n=4 SMR, n=1 PMR) an 18.5% in the surgical group (n=5 deaths; all SMR patients). In the midterm FU over 18 months (Figure 1), the surgically treated patients with SMR showed a significantly higher mortality rate than in patients with PMR (p=0.002). In the Reclip intervention group, no significant difference between treated PMR and SMR patients can be objectified (p=0.995). The comparison between surgery / reclip in the PMR group shows no significance, whereas a trend (p=0.148) in favor of the reclip can be distinguished between surgery / reclip in SMR in the outcome. Conclusion Surgically treated patients after AFP with an SMR as index etiology show a very poor short and medium-term survival both in comparison to the PMR patients and to the two reclip groups. With the combination of AFP and SMR, the reclip treatment can be regarded as the primary treatment option despite the lack of statistical significance compared to surgery. In return, surgery combined with AFP and PMR offers a viable alternative and can be favored over the reclip procedure in younger patients. Kaplan-Meier plot of the 4 intervention groups Funding Acknowledgement Type of funding source: None

First evaluation of Neighbor of Punc E11 (NOPE) as a novel marker in human hepatocellular carcinoma.

Hepatocellular carcinoma (HCC) is the second most common cause of cancer death worldwide and the search for clinically useful biomarkers is ongoing. Neighbor of Punc E11 (NOPE) is an established biomarker of murine HCC that remains undetectable in normal liver and at preneoplastic stages. The aim of our study was to evaluate the presence of NOPE in human HCC. Histologically confirmed HCC and corresponding non-tumor liver samples from 20 patients were analyzed for expression of NOPE using qRT-PCR and mRNA-in-situ technology in a conserved tissue context. In our cohort, 30% of HCC samples were expressing NOPE which proved particularly useful in non-cirrhotic HCC samples with up to 155-fold higher expression than in adult liver. Using mRNA-in-situ technology, NOPE was clearly identified within epithelial tumor cells of NOPE positive human HCCs. In our analyzed cohort, the combination of AFP with NOPE did not reach more than 40% sensitivity while GPC-3 and NOPE were complementary to each other reaching a combined sensitivity of 85.7%. This is the first characterization of NOPE as a potential biomarker for human HCC. Our results underline the value of NOPE as a complementing biomarker for human HCC.

THU464 - Combination of AFP, AFP-l3 and PIVKA-II levels improves diagnostic accuracy of hepatocellular carcinoma (ALPS score)

THU464 - Combination of AFP, AFP-l3 and PIVKA-II levels improves diagnostic accuracy of hepatocellular carcinoma (ALPS score)

Circulating circRNA predicting the occurrence of hepatocellular carcinoma in patients with HBV infection

A microarray‐based high‐throughput screening of human circulating circular RNA (circRNA) was applied with five patients newly diagnosed with hepatocellular carcinoma (HCC), five patients with HBV‐positive chronic hepatitis (CH) and five healthy controls (NC) enrolled. The plasma of HCC patients after hepatectomy was also collected. After multiple staged validation, we obtained five circRNAs as candidate. Based on the stratified risk score analysis, three increased circRNAs including circ_0009582, circ_0037120 and circ_0140117 were confirmed as candidate circulating fingerprints for distinguishing HCC from CH or NC group. With the combination of AFP, higher sensitivity and specificity were further guaranteed, suggesting that circ_0009582, circ_0037120 and circ_0140117 may serve as potential biomarkers for predicting the occurrence of HCC in patients with HBV infection.

The Diagnostic role of Soluble (sAxl) Level in Patients with Hepatocellular Carcinoma compared to Alpha-fetoprotein

Background and Aim: Hepatocellular carcinoma deemed for the plurality of primary liver cancers. Malignancy of the liver is the fourth most popular etiology of cancer mortality worldwide. The high mortality of HCC cases is linked to the delay in diagnosis. Aberrant expression of Axl frequently occurs in many malignancies and is critical for promoting cell proliferation, migration, angiogenesis and metastasis. Axl deregulated activation or expression is linked to resistance to targeted cancer therapies. we aimed to to clear up the diagnostic role of sAXL in HCC patients. Methods: Study included 90 participants; 40 HCC patients on top of liver cirrhosis, 30 patients with liver cirrhosis and twenty healthy subjects (controls). CBC, liver and kidney function tests, alpha-fetoprotein, abdominal ultrasound and triphasic CT were performed. sAxl was assessed by ELISA. Results: sAxl was considerably higher in HCC patients than in cirrhotic and control participants (p 63.5, AFP at cut off >40.34 has sensitivity, specificity and AUC 57.5%, 60% and 0.675 respectively. The combination of AFP and sAxl at related cut off points has higher sensitivity (97.5%) and AUC 0.972 in predicting HCC in cirrhotic patients. sAxl was positively correlated with tumor size. Conclusion: sAxl outperforms AFP in detecting HCC, especially in early HCC and in AFP-negative HCC. Combination of sAxl with AFP improved the sensitivity for early HCC diagnosis.

Soluble Axl Is a Novel Diagnostic Biomarker of Hepatocellular Carcinoma in Chinese Patients with Chronic Hepatitis B Virus Infection.

PurposeThe purpose of this study was to evaluate the diagnostic value of soluble Axl (sAxl) in hepatocellular carcinoma (HCC) in comparison with serum α-fetoprotein (AFP).Materials and MethodsEighty HCC patients, 80 liver cirrhosis patients (LC), 80 patients with hepatitis B virus (HBV) infection, and 80 healthy controls (HC) were enrolled. sAxl levels were measured by an enzyme-linked immunosorbent assay, serum AFP levelswere measured by an electrochemiluminescence immunoassay. Receiver operating characteristic (ROC) curves were used to evaluate diagnostic performances.ResultsThe results show that levels of sAxl were high expression in patients with HCC (p < 0.05), varied with disease state as follows: HCC > LC > HC > HBV. Logistic regression and ROC curve analysis identified the optimal cut-off for sAxl in differentiating all HCC and non-HCC patients was 1,202 pg/mL (area under the receiver operating characteristic [AUC], 0.888; 95% confidence interval [CI], 0.852 to 0.924) with sensitivity 95.0%, specificity 73.3%. Furthermore, differential diagnosis of early HCC with non-HCC patients for sAxl showed the optimal cut-off was 1,202 pg/mL (AUC, 0.881; 95% CI, 0.831 to 0.931; sensitivity, 94.1%; specificity, 73.3%). Among AFP-negative HCC patients with non-HCC patients, the cut-off was 1,301 pg/mL (AUC, 0.898; 95% CI, 0.854 to 0.942) with a sensitivity of 84.6%, a specificity of 76.3%. The optimal cut-off for sAxl in differentiating all HCC and chronic liver disease patients was 1,243 pg/mL (AUC, 0.840; 95% CI, 0.791 to 0.888) with sensitivity 93.8%, specificity 61.9%. The combination of AFP and sAxl increased diagnostic value for HCC.ConclusionsAxl outperforms AFP in detecting HCC, especially in early HCC and in AFP-negative HCC. Combination sAxl with AFP improved the specificity for early HCC diagnosis. In summary, sAxl is a candidate serum marker for diagnosing HCC.

A Comparative Study of the Diagnostic and Prognostic Value of Squamous Cell Carcinoma Antigen and Alfa-foeto Protien in Hepatocellular Carcinoma Before and After Therapeutic Intervention

Abstract Background hepatocellular carcinoma (HCC) is one of the most common malignancies worldwide and it is one of the major causes of death, because of its high frequency and poor prognosis. Hepatocellular carcinoma is now a common malignancy in Egypt which usually develops on top of liver cirrhosis secondary to viral infection, as hepatitis C viruses increased the risk of HCC in the Egyptian patients. Aim of the Work was to verify the possibility of using the plasma squamous cell carcinoma antigen level as a tumor marker for hepatocellular carcinoma and to evaluate its prognostic value in management of HCC. Patients and Methods the study included 60 subjects divided into three groups: group I was 30 patients with hepatocellular carcinomas, group II was 15 patients with liver cirrhosis and group III was 15 normal subjects serving as a control group. Follow up of the patients who had HCC and undergone either RFA or TACE will be done after 1 month by measuring serum level of alfa feto protein &amp; SCCA. Results the plasma SCCA level was significantly higher in group I patients (with HCC), than in the group II patients (cirrhosis) and control group. SCCA showed direct significant correlation with the most of laboratory data specially AST, INR, number and size of lesion and its values were decreased after intervention. Conclusion plasma SCCA is a sensitive and specific serum marker for the diagnosis and prognosis of HCC and combination of AFP and SCCA in screening and diagnosis of HCC yielded a better sensitivity in diagnosis of HCC.

Impact of surgical margin according to AFP rate before hepatectomy for hepatocellular carcinoma

Introduction: Surgical margins in hepatocellular carcinoma (HCC) are required to remove potential satellite nodules and microvascular invasion. The aim of this study was to assess if preoperative tumors with high AFP (>100 ng/ml) required wider margins than tumors with low AFP. Methods: Between April 2012 and January 2016, all patients (n=397) who underwent a first hepatectomy without macroscopic remnant disease (R2) were analyzed in eHPBChir Group (5 centers). Preoperative prognostic factors for time to recurrence were analyzed in univariate and multivariate analysis. The impact of surgical margins (≥ 1 cm or not), in patients with AFP rate inferior or superior to 100 ng/ml on the time to recurrence (TTR) and the overall survival (OS) were studied. Results: Preoperative high AFP rate (> 100 ng/ml) was observed in 98/397 (25%) patients and resection margin < 1cm was retrieved in 247/397 (62%) patients. The comparison of low and high AFP patient groups was summarized in table 1. In multivariate analysis, the only prognostic factor for TTR was a combination of AFP > 100 ng/mL and resection margin < 1cm (HR=2.438; IC95% [1.709-3.478]; p< 0.001). In patients with high AFP rate, surgical margin highly impacted TTR contrary to patients with low AFP rate where surgical margin had no impact on TTR (graph 1). There is a trend for better OS according to AFP and margin that did not reach significance. Conclusion: Surgical margins ≥1 cm highly impacted recurrence in patients with AFP>100 but not in patients with AFP≤100.

A Comparative Study of the Diagnostic and Prognostic Value of Squamous Cell Carcinoma Antigen and Alfa-foeto Protien in Hepatocellular Carcinoma Before and After Therapeutic Intervention

Background: hepatocellular carcinoma (HCC) is one of the most common malignancies worldwide and it is one of the major causes of death, because of its high frequency and poor prognosis. Hepatocellular carcinoma is now a common malignancy in Egypt which usually develops on top of liver cirrhosis secondary to viral infection, as hepatitis C viruses increased the risk of HCC in the Egyptian patients. Aim of the Work: was to verify the possibility of using the plasma squamous cell carcinoma antigen level as a tumor marker for hepatocellular carcinoma and to evaluate its prognostic value in management of HCC. Patients and Methods: the study included 60 subjects divided into three groups: group I was 30 patients with hepatocellular carcinomas, group II was 15 patients with liver cirrhosis and group III was 15 normal subjects serving as a control group. Results: the plasma SCCA level was significantly higher in group I patients (with HCC), than in the group II patients (cirrhosis) and control group. SCCA showed direct significant correlation with the most of laboratory data specially AST, INR, number and size of lesion. Conclusion: plasma SCCA is a sensitive and specific serum marker for the diagnosis of HCC and combination of AFP and SCCA in screening and diagnosis of HCC yielded a better sensitivity in diagnosis of HCC.

A Comparative Study of the Diagnostic and Prognostic Value of Squamous Cell Carcinoma Antigen and Alfa-foeto Protien in Hepatocellular Carcinoma Before and After Therapeutic Intervention

Background: hepatocellular carcinoma (HCC) is one of the most common malignancies worldwide and it is one of the major causes of death, because of its high frequency and poor prognosis. Hepatocellular carcinoma is now a common malignancy in Egypt which usually develops on top of liver cirrhosis secondary to viral infection, as hepatitis C viruses increased the risk of HCC in the Egyptian patients. Aim of the Work: was to verify the possibility of using the plasma squamous cell carcinoma antigen level as a tumor marker for hepatocellular carcinoma and to evaluate its prognostic value in management of HCC. Patients and Methods: the study included 60 subjects divided into three groups: group I was 30 patients with hepatocellular carcinomas, group II was 15 patients with liver cirrhosis and group III was 15 normal subjects serving as a control group. Results: the plasma SCCA level was significantly higher in group I patients (with HCC), than in the group II patients (cirrhosis) and control group. SCCA showed direct significant correlation with the most of laboratory data specially AST, INR, number and size of lesion. Conclusion: plasma SCCA is a sensitive and specific serum marker for the diagnosis of HCC and combination of AFP and SCCA in screening and diagnosis of HCC yielded a better sensitivity in diagnosis of HCC.

Diagnostic accuracy of SCCA and SCCA-IgM for hepatocellular carcinoma: A meta-analysis.

Squamous cell carcinoma antigen (SCCA) and its immune complex (SCCA-IgM) have been proposed for use in the screening of hepatocellular carcinoma (HCC). We conducted a meta-analysis to evaluate the diagnostic performance of SCCA and SCCA-IgM and of both combined with alpha-foetoprotein. After a systematic review of the relevant studies, the sensitivity, specificity, positive and negative likelihood ratios, diagnostic odds ratio (DOR) and area under curve (AUC) for the diagnosis of HCC were pooled using bivariate meta-analysis. Hierarchic summary receiver operating characteristic curves were used to summarize the overall test performance. Bivariate boxplots were used to confirm whether the threshold effect existed. A Fagan nomogram was used to assess the clinical utility. Heterogeneity was explored by sensitivity analysis, univariable meta-regression and subgroup analysis. Eleven studies that had HCC diagnosis as their purpose were ultimately included in the quantitative analysis. The summary estimates were as follows: SCCA (AUC: 0.80 [95% CI: 0.76-0.83]) and SCCA-IgM (AUC: 0.77 [95% CI: 0.74-0.83]) demonstrated similar diagnostic performance, while a combination of AFP and SCCA-IgM had an AUC of 0.90 (95% CI: 0.87-0.92) and a DOR of 22.87 (95% CI: 8.38-62.40). Meta-regression showed that patient selection, cut-off values, reference standards and tumour biopsy as the diagnostic method significantly influenced the heterogeneity of the included studies. Both SCCA and SCCA-IgM showed a moderate diagnostic accuracy for HCC screening; the combination of SCCA-IgM and AFP is the best diagnostic option.

Combination of serum tumor markers dickkopf-1, DCP and AFP for the diagnosis of primary hepatocellular carcinoma.

To evaluate the detection accuracy of the biomarkers dickkopf-1, DCP and AFP as a serum biomarker panel by comparing the sensitivity of the panel with those of the individual biomarkers. The study was composed of three groups, one with HCC patients, one with non-HCC liver diseases and one with healthy controls. Serum AFP was measured using a chemiluminescence assay and serum dickkopf-1 and DCP were measured with ELISA. The sensitivity and specificity of the biomarkers were analyzed as single parameters and as a serum panel. The HCC group showed higher levels of dickkopf-1, DCP and AFP than the other two groups (P<0.05). Dickkopf-1 showed better sensitivity (73.26% vs. 58.13%, P<0.05) and better specificity (44.0% vs. 29.0%, P<0.05) than AFP. DCP also had better sensitivity (74.42% vs. 58.13%, P<0.05) than AFP, but their specificity was similar (30.00% vs. 29.00%, P>0.05). The combination of the biomarkers as a serum panel produced much better sensitivity (93.02%) and specificity (78.00%) than each of the markers individually (P<0.05). The combination of AFP, DCP and dickkopf-1 as a biomarker panel can significantly improve the detection power with much higher sensitivity and specificity for HCC than any of the biomarkers alone. The tests are convenient and inexpensive, and may serve as a valuable addition to current options for the diagnosis of HCC.

HISTAMINE IS A HELPFUL NOVEL SEROLOGICAL BIOMARKER FOR EXPERIMENTAL HEPATOCELLULAR CARCINOMA

Aim of the study: Like other cancers, HCC progression is highly affected by angiogenesis and apoptosis. The present study aims to assess the potential role of the endogenous regulators of angiogenesis and apoptosis like neurotransmitters, as possible hepatocellular carcinoma (HCC) biomarkers. Materials and methods: Five groups of rats were used in this study: a control healthy group(I) and another four intoxicated groups used for induction of HCC with a single dose of diethylnitrosamine (DENA 200 mg/kg, single I.P. dose), (II, III, IV, and V). Groups II, III, IV, and V were sacrificed following 8,16,24, and 32 weeks of the DENA injection respectively. Level of histamine serum samples was estimated using high performance liquid chromatography technique coupled with Diode array detector (HPLC-DAD). In addition, AFP was measured using ELISA technique. Results: Development of HCC was confirmed by histopathological studies. The results exhibited prominent increase in serum histamine level during early and moderate stages of HCC development (group II, III, and IV) in comparison to the control, then histamine serum level declined to the normal level during last stage of HCC development (group V). Conclusion: Histamine can be used in combination of AFP as a biomarker for detection of early stages of HCC where AFP alone has a limited detection value.

Expression and diagnostic value of CCT3 and IQGAP3 in hepatocellular carcinoma.

BackgroundTo evaluate plasma chaperonin containing TCP1 complex subunit 3 (CCT3) and IQ-motif-containing GTPase-activating protein-3 (IQGAP3) as biomarker for hepatocellular carcinoma (HCC) screening and diagnosis.MethodsBlood samples were collected from 126 HCC patients with HCC, 88 patients with cirrhosis and 50 healthy volunteers to detect plasma α-fetoprotein (AFP), CCT3 and IQGAP3 levels. Plasma AFP, CCT3 and IQGAP3 protein levels were measured by enzyme linked immunosorbent assay (ELISA).ResultsIn the plasma of HCC patients, both CCT3 and IQGAP3 were significantly higher than in patients with cirrhosis and in healthy controls (P < 0.01). CCT3 and IQGAP3 protein level correlated well with HCC etiology, tumor size, TNM stage, and child-pugh classification. CCT3 protein had higher sensitivity in the diagnosis of HCC when compared with AFP (87.3 vs 69.8 %). In addition, CCT3 and IQGAP3 protein were able to complement AFP in detecting AFP-negative HCC patients with sensitivity and specificity of 92.1 and 70.5 % and 81.6 and 71.6 %, respectively. In the small HCC group, CCT3 and IQGAP3 protein had sensitivity of 76.6 and 74.5 %, respectively. The combination of AFP + CCT3 + IQGAP3 (0.954) had significantly superior discriminative ability than AFP alone (0.815; P < 0.01).ConclusionsCCT3 and IQGAP3 are novel complementary biomarkers for HCC screening and diagnosis, especially for AFP-negative and small HCC patients.

Accuracy of novel diagnostic biomarkers for hepatocellular carcinoma: An update for clinicians (Review).

Hepatocellular carcinoma (HCC) is the most common liver malignancy and a leading cause of cancer-related mortality worldwide. Accurate detection and differential diagnosis of early HCC can significantly improve patient survival. Currently, detection of HCC in clinical practice is performed by diagnostic imaging techniques and determination of serum biomarkers, most notably α-fetoprotein (AFP), fucosylated AFP and des-γ-carboxyprothrombin. However, these methods display limitations in sensitivity and specificity, especially with respect to early stages of HCC. Recently, high-throughput technologies have elucidated many new pathways involved in hepatocarcinogenesis and have led to the discovery of a plethora of novel, non-invasive serum biomarkers. In particular, the combination of AFP with these new candidate molecules has yielded promising results. In this review, we aimed at recapitulating the most recent (2013–2015) developments in HCC biomarker research. We compared promising novel diagnostic serum protein biomarkers, such as annexin A2, the soluble form of the receptor tyrosine kinase Axl and thioredoxin, as well as their combinations with AFP. High diagnostic performance (area under the curve >0.75) as shown by threshold-independent receiver operating characteristic curve analysis was a prerequisite for inclusion in this review. In addition, we discuss the role and potential of microRNAs in HCC diagnosis and associated methodological challenges.