الفهرس 
Hepatocellular Carcinoma
Gamma-glutamyl transferase:Only 14 pages are availabe for public view
 |  | from | 173 |  |  |
| | | from | 173 | | |
Abstract
Summary & conclusion
This study was conducted on 70 adult subjects selected from
Tropical medicine Department Tanta University Hospital. The
subjects were divided into three groups:
group I (Control group), This group include 10 apparently
healthy subjects, their ages ranged from 42 to 63 years. They
were 7 males and 3 females. They were sero-negative for
hepatitis B surface markers and HCV antibodies and with normal
liver function tests.
group II (Cirrhotic group), This group include 30 patients
with liver cirrhosis. Their ages ranged from 43 to 62 years. They
were 22 males 8 females. They were diagnosed by
ultrasonographical findings (shrunken liver, coarse echo pattern,
attenuated hepatic vein and fine nodular surface) and
biochemical evidence of parenchymal damage as well as liver
biopsy in some cases.
group III (HCC group), This group include 30 patients with
HCC. Their ages ranged from 40 to 65 years. They were 23
males 7 females. The diagnosis of HCC was by clinical
examination, radiological investigations including abdominal
ultrasonography, triphasic CT and laboratory investigation.
All patients subjected to the following
Past history taking and thorough clinical examination.
1. Abdominal ultrasonography.
2. Triphasic C.T.
3. Routine laboratory investigation: - Liver function tests including: ALT, AST, serum albumin,
total and direct bilirubin.
- Complete blood count.
- Fasting and 2-hours post prandial blood glucose levels.
- Blood urea and serum creatinine.
- Prothrombin time and INR.
- Serum AFP.
- Hepatitis markers will be done by ELISA (HCV-Abs and
HBSAg) and confirmed with quantitative PCR for positive
cases.
4. Sepcific laboratory investigation:
Determination of serum Alpha L-Fucosidase (by ELISA kits
for Alpha L-Fucosidase.
The results of this study revealed that:
There were no statistically significant difference in the mean
values of ages or gender in all Studied groups.
There was statistically significant increase in percentage of
PVT in HCC group when compared to cirrhotic group, but
there was no statistically significant difference in comparsion
between the same groups regarding ascities and Child Pugh
Score.
There were a statistically significant increase in AST, ALT,
total bilirubin, INR and significant decrease in serum
albumin in both HCC and cirrhotic group when compared to
control group. In contrast there were no statistically
significant difference when comparing these laboratory
investigations between cirrhotic group and HCC group. There was statistically significant decrease in mean value of
HB levels in cirrhotic group when compared to control group
and in HCC group when compared to control group as well
as in cirrhotic group when compared to HCC group. The
mean value of WBC was statistically significant increase in
cirrhotic group as well as HCC group when compared to
control group, no statistically significant difference was
found between HCC group and cirrhotic group.
There was statistically significant decrease in the mean
values of platelets in cirrhotic group and HCC group when
compared to control group, while there was no statistically
significant difference was found between HCC group and
cirrhotic group.
There was statistically significant increase in mean values of
serum AFU in HCC group when compared to both cirrhotic
group and control group
Also there was statistically significant increase in mean
values of serum AFU in cirrhotic group when compared to
control group.
No correlation between AFU and number of focal lesions.
There is no correlation between the two markers and
different stages of Child Pugh score.
AFU at optimal cut- off value 63 ng/ml had better
performance AFP at a cut-off value 28ng/ml for Hcc
diagnosis. The sensitivity and specificity of AFU were 96
&93 respectively, vs 93&89 for AFP, with area under The
ROC curve of 0.974 vs. 0.943 for AFU vs. AFP,
respectively.CONCLUSIONS
In the present study, we concluded that serum Alpha-LFucosidase
has better performance than AFP in diagnosis of HCC
especially in the early stage.
In addition to AFP, measurement of serum AFU can further
improve the diagnosis of HCC so, serum AFU may be considered a
promising HCC biomarker.