الفهرس | Only 14 pages are availabe for public view |
Abstract Hepatocellular carcinoma (HCC) is considered the 6th common cancer all over the world and it is accounting for 75% to 85% of primary liver cancers. HCC is in the fourth place as a cause of cancer death. AFP is the most commonly used biomarker for detecting and monitoring HCC. However, the sensitivity and specificity of AFP are not satisfactory. Cell free DNA is short fragment of double-stranded DNA that can be detected in both healthy individuals and patients with diseases. It is related to apoptosis and necrosis of cancer cells. Also, inflammation influences the total plasma level of cfDNA. This work aimed to evaluate the clinical significance of cfDNA as a diagnostic biomarker in HCC comparing with AFP. This study included 90 subjects that were divided into 3 groups: Control group (which included 30 apparently healthy subjects), benign group (which included 30 patients diagnosed as benign liver diseases) and HCC group (which included 30 patients diagnosed as HCC). All participants were submitted to the followings: full history taking and clinical examinations for disease diagnosis. Also, routine laboratory investigations including: liver function tests, CBC, AFP and detection of cfDNA concentration & integrity by real time PCR technique. Moreover, abdominal ultrasongraphy for tumor size, triphasic CT abdomen & Child-Pugh classification for patients groups were done. The results were tabulated and statistically analyzed. The results revealed that: All studied groups were matched regarding age and gender, as there were no significant statistical differences among the studied groups (p = 0.181 and 0.955 respectively). There were high significant statistical differences among studied groups regarding ALT, AST, total bilirubin, albumin, HB, platelet count, prothrombin conc., INR and AFP (P = 0.001). Regarding AFP level ; There were high significant statistical differences in the median level of AFP among the studied groups (p =0.001). Regarding cfDNA integrity ; There were high significant statistical differences in the median level of plasma cfDNA integrity among the studied groups (p= 0.001). Regarding correlation between cfDNA Integrity and other studied variables in HCC group; There was significant positive correlation between cfDNA integrity and PT conc in HCC group (p = 0.049). Meanwhile, there was no statistical significant correlation were found between cfDNA and other parameters Receiver operating characteristic (ROC) graph; Revealed that the best cut off level of cfDNA Integrity was ≤o.93 for discrimination between benign and HCC groups. The sensitivity was 100%, the specificity 83%, positive predictive value 100%, negative predictive value 86% and accuracy 92%. Receiver operating characteristic (ROC) graph; Revealed that the best cut off level of AFP was 49.3 for discrimination between benign and HCC groups. The sensitivity was 97%, the specificity 100%, positive predictive value 98%, negative predictive value 100% and accuracy 99%. Receiver operating characteristic (ROC) graph for both cfDNA Integrity and AFP for discrimination between benign and HCC groups; Revealed that the sensitivity was 100%, the specificity 80%, positive predictive value 83%, negative predictive value 100% and accuracy 90%. |