Diagnostic and Predictive Value of Some Tumor Markers in the Diagnosis and Follow Up of Patients with Hepatocellular Carcinoma | ||||
| Bulletin of Egyptian Society for Physiological Sciences | ||||
| Article 17, Volume 29, Issue 2, December 2009, Page 229-246 PDF (246.37 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/besps.2009.36729 | ||||
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| Authors | ||||
| Ghada Abdel-Aleem* 1; Ayman Wagih1; Sabry Abousaif2; Mona Abdel-Azem3 | ||||
| 1Department of Medical Biochemistry, Faculty of Medicine, Tanta University | ||||
| 2Department of Tropical, Faculty of Medicine, Tanta University | ||||
| 3Department of Pathology, Faculty of Medicine, Tanta University | ||||
| Abstract | ||||
| Early detection of hepatocellular carcinoma (HCC) is essential for successful treatment. Although the role of alpha fetoprotein (AFP) in the diagnosis of advanced HCC is well recognized, at least one third of small HCCs and 15–20% of advanced HCC will be missed unless another diagnostic tool is used. Thus, new serologic markers with sufficient sensitivity and specificity are required. In the present study, we aimed at evaluating the diagnostic and prognostic role of AFP, protein induced by vitamin K absence or antagonist(P1VKA-II), vascular endothelial growth factor (VEGF), sialic acid, alpha-L-fucosidase (AFU) and transforming growth factor-beta 1 (TGF-β1) in the diagnosis and follow up of Egyptian patients with hepatocellular carcinoma in an attempt to find a tumor marker with a reasonable sensitivity and specificity for diagnosis of HCC and monitoring patients after therapy. The study was conducted on 4 selected groups of patients and a control group. Group I included 10 patients with liver cirrhosis. Group II consisted of 10 patients with benign hepatic focal lesions. Group III included 10 HCC patients without distant metastasis and group IV included 10 HCC patients presenting with metastasis. Ten apparently healthy age and sex matched subjects were also included and served as control group. AFP, sialic acid, alpha-L-fucosidase (AFU), VEGF, PIVKA-II and TGF- β1 were determined in the blood of five studied groups. The sensitivity and specificity of the tumor markers were calculated and compared. Significant differences in the median blood levels of AFP, PIVKA-II, VEGF, sialic acid, TGF- β1 and alpha-L-fucosidase activity (AFU) were found on comparing the HCC groups (with and without metastasis) with the other groups. The median blood levels of PIVKA- II, α-fetoprotein level, sialic acid and AFU activity were lower in the HCC group without metastasis compared to that with metastasis (p<0.001). On the other hand, the median serum VEGF level was higher in the HCC group without metastasis compared to that of the HCC group with distant metastasis(p<0.001). Serum TGF- β1 level did not vary significantly between both groups (with and without metastasis) (p>0.05). There were significant lower median blood levels of all parameters in HCC patients without metastasis after ablation therapy compared to pretreatment levels. Combined determination of serological markers could be used as a highly valuable tool for screening and diagnosis of HCC as combination of these markers improved their sensitivity and specificity. They could also be used as prognostic markers decreasing the need for more invasive procedures. | ||||
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