Title: Clinical Utility of Alfa- Fetoprotein-L3 in Hepatocellular Carcinoma Patients

Authors:Ayman Mohamed Shamseya, Wafaa Mohamed Hussein Elsheikh, Mohamed Mohamed Shamseya, Amal El Mahdi Mohamed Shafaey, Khaled Mustapha Belal&Waleed Said Mohamed Moftah

 DOI:  http://dx.doi.org/10.18535/jmscr/v3i11.14

Abstract

Patients at risk for HCC should undergo surveillance with ultrasonography, CT scan, or MRI at 6-monthly intervals. Serum-α-fetoprotein (AFP) and protein induced vitamin K absence (PIVKA)-II are the most common markers available to detect HCC. Des gamma carboxyprothrombin (DCP), AFP-L3 (a glycosylated form of AFP which is produced in higher concentration by HCC than normal liver), Golgi membrane protein 73 (GP73), and glypican 3 (GPC3) have been proposed as surveillance tests for HCC. In patients with small tumors or in well-to-moderately differentiated HCC, serum markers rarely elevated. Therefore, there is a need for the development of more sensitive and specific methods that supplement these tumor markers for the early detection of HCC. The present study included 46 patients with HCC, 20 patients with benign hepatic disorders and 20 sex- and age- matched apparent healthy individuals as a control group. The median value of both serum AFP-L3 and AFP-L3/AFP ratio was significantly higher in HCC patients group compared to other groups. There was a significant positive correlation between each of serum AFP, AFP-L3, with each of child classification, tumor size and tumor number, among HCC patients. The best cut-off point for AFP as predictor of HCC was 62 ng/mL, for AFP-L3 as predictor of HCC was 15 ng/mL and for AFP-L3/AFP ratio was 20 %. Combination of AFP and AFP-L3 revealed best cut-off of AFP at 100 ng/mL and AFP-L3 at 4 ng/mL. In conclusion AFP-L3 is a promising marker for diagnosis of HCC especially when combined with AFP.

Keywords: Alfa- Fetoprotein, Hepatocellular Carcinoma, tumor markers.

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Corresponding Author

Dr Ayman Mohamed Abdou Shamseya

Lecturer, Department of Internal Medicine, Faculty of Medicine, University of Alexandria, Egypt

Address: 21, Elsayed Radwan St, Miami, Alexandria, Egypt

Email: This email address is being protected from spambots. You need JavaScript enabled to view it., Phone: +201222903176