Alpha-L-Fucosidase Versus Alpha-Fetoprotein: A Comparative Study for Diagnosing Hepatocellular Carcinoma in Post-Viral Cirrhotic Patients | ||||
| Ain Shams Medical Journal | ||||
| Volume 76, Issue 1, March 2025, Page 185-196 PDF (438.41 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/asmj.2025.350384.1361 | ||||
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| Authors | ||||
Sherif Ahmed Megahed   1; Sameh Moamed Faheem Ghaly2; Moamen Abd-elfattah Shabaan2; Marwa Ahmed Mohamed Mohamed Sakr2
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| 1Internal Medicine Department, Faculty of Medicine, Ain Shams University | ||||
| 2Internal Medicine, Hepatology and Gastroenterology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt. | ||||
| Abstract | ||||
| Background: Hepatocellular carcinoma (HCC) is a leading cause of cancer-related mortality worldwide, particularly in patients with viral cirrhosis. Alpha-fetoprotein (AFP) is widely used for HCC diagnosis; however, it suffers from limited sensitivity and specificity, especially in early-stage HCC. Alpha-L-fucosidase (AFU) has emerged as a potential biomarker for HCC detection. Aim of the Work: To evaluate AFU diagnostic performance compared to AFP in Egyptian patients with HCC post-viral cirrhosis. Patients and Methods: A cross-sectional case-control study was carried out on 90 participants divided into three groups: HCC patients with viral cirrhosis (n=30), cirrhosis-only patients (n=30), and healthy controls (n=30). Serum AFP and AFU levels were measured using ELISA. Results: AFU levels were considerably higher in HCC patients (129.87±32.99 U/ml) compared to cirrhotic (33.43±14.82 U/ml, P-value <0.001) and healthy controls (3.18±1.20 U/ml, P-value <0.001). AFP levels were also elevated in HCC patients (4431.21±11438.90 ng/ml) versus cirrhotic (883.83±973.62 ng/ml, P-value <0.05) and healthy controls (P-value <0.001). AFU demonstrated 100% sensitivity and 90% specificity at a cutoff >52 U/ml, with an accuracy of 99.4%. AFP showed 96.67% sensitivity and specificity at a cutoff >10.5 ng/ml, with 97.6% accuracy. Conclusion: AFU is a highly sensitive and complementary biomarker to AFP for HCC diagnosis in cirrhotic patients. Combining AFU and AFP may improve early detection of HCC, particularly in AFP-negative cases. | ||||
| Keywords | ||||
| Alpha-L-fucosidase; alpha-fetoprotein; biomarkers; cirrhosis; hepatocellular carcinoma | ||||
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