الفهرس | Only 14 pages are availabe for public view |
Abstract Hepatocellular carcinoma (HCC) is one of the most common malignancies worldwide and it is one of the major causes of death. AFP was the only tumour marker that is used for early diagnosis of HCC. However, it was found that it is associated with false positive and false negative results. So,there was a great demand by clinicians to find new HCC specific tumour markers. AFP-L3 is the major glycoform found in individuals with HCC. Aim : The aim of this study was to determine serum AFP-L3 in HCC patients, estimate the ratio of AFP-L3 to total AFP and to correlate the AFP-L3% with the tumour burden. Methods:This study was performed on 64 patients; 47 patients had HCC and 17 patients had liver cirrhosis. Both groups were subjected to history taking, clinical examination, routine laboratory evaluation, serum AFP, serum AFP-L3 ultrasound examination and disease severity assessment by Child-Pugh classification, MELD score, BCLC score. Results: We found that, mean values of AFP-L3 were higher in HCC patients as compared to cirrhosis patients . There was a significant relation between AFP and AFP-L3% at cutoff value of 5% and 10% in patients with AFP (10-200ng/ml). AFP was significantly higher among HCC patients when compared to cirrhosis patients. There was a non significant relation between AFP-L3% and age of patients,biochemical lab results, the number ,the diameter of the hepatic focal lesions, Child- Pugh, MELD and BCLC scores.The best cutoff value for AFP in this study was 62.5ng/ml which yielded a sensitivity, a specificity, PPV, NPV of 79%, 47%, 80% and 44.4% respectively.There was a significant positive relation between AFP and the diameter of the tumour foci.However,a non significant relation with number of tumour foci,BCLC staging and Child Pugh and MELD scores. Conclusion: The target population for AFP-L3% might be those chronic liver disease patients who have AFP concenterations in the intermediate range of 10-200ng/ml and a small or intermediate mass on imaging. |