A simple diagnostic index comprising epithelial membrane antigen and fibronectin for hepatocellular carcinoma
Journal Title: Annals of Hepatology - Year 2015, Vol 14, Issue 6
Abstract
Background and rationale for the study. Continuing search for suitable tumor-markers is of clinical value in managing patients with various malignancies. These markers may be presented as intracellular substances in tissues or may be released into the circulation and appear in serum. Therefore, this work is concerned with identification and quantitative determination of epithelial membrane antigen (EMA) and fibronectin and estimating their performances as surrogate markers for identifying hepatocellular carcinoma (HCC). Results. A total of 627 individuals constituted this study [fibrosis (F1-F3) = 217; cirrhosis = 191; HCC = 219]. Western-blot was used for identifying EMA and fibronectin in sera. As a result, a single immunoreactive band was shown at 130-kDa and 90-kDa corresponding to EMA and fibronectin, respectively. They were quantified using ELISA providing values in HCC higher than fibrosis or cirrhosis with a significant difference (P < 0.0001). For identifying HCC, EMA showed 0.82 area under receiver-operating characteristic curve (AUC) with sensitivity = 70% and specificity = 78% while fibronectin yielded AUC = 0.70 with sensitivity = 67% and specificity = 82%. FEBA-Test comprising fibronectin and EMA together with total-bilirubin and AFP was constructed yielding AUC = 0.92 for identifying HCC from cirrhosis with sensitivity = 89% and specificity = 85%. FEBA-Test was then tested for differentiating HCC from fibrosis showing AUC = 0.97 with sensitivity = 90% and specificity = 89%. FEBA-Test enabled the correct identification of HCC patients with CLIP 0-1 and size ≤ 3 cm with AUC = 0.80 and AUC = 0.84, respectively, indicating its ability in identifying early HCC.Conclusions. A four-marker index may improve the early detection of HCC with a high degree of accuracy.
Authors and Affiliations
Abdelfattah Attallah, Mohamed El-Far, Camelia Abdel Malak, Khaled Farid, Raida Yahya, Entsar Saad, Ahmed Attallah, Islam Ali, Safaa Abed
Undifferentiated embryonal sarcoma of liver in an adult masquerading as complicated hydatid cyst
Benign or malignant hepatic lesions may rarely mimic inflammatory lesions on imaging. We describe a case of young adult male presenting with pain abdomen and fever of short duration. Imaging revealed large complex multis...
The use of sildenafil to treat portopulmonary hypertension prior to liver transplantation
Portopulmonary hypertension (PPH) is an infrequent, but well-recognized complication of liver cirrhosis. PPH in those with end-stage liver disease has a significant impact on per-operative and intra-operative mortality,...
Role of nonalcoholic fatty liver disease in hepatocellular carcinoma
Obesity and related disorders are a common cause of morbidity worldwide. Nonalcoholic fatty liver disease is the most important hepatic consequence of adipose accumulation. There is strong evidence of obesity-related dis...
Natural history of hepatitis C virus infection in a cohort of asymptomatic post-transfused subjects
Background & aims. Studies about the natural history of hepatitis C virus (HCV) infection report variable progression to cirrhosis depending on study design. Retrospective cross-sectional liver clinic studie...
Efficacy of maintenance subcutaneous hepatitis B immune globulin (HBIG) post-transplant for prophylaxis against hepatitis B recurrence.
Background. Patients who receive liver transplantation for chronic hepatitis B infection require long-term combination therapy with hepatitis B immunoglobulin (HBIG) and oral antiviral medication to prophylax against gra...