Clinical Utility of Alfa- Fetoprotein-L3 in Hepatocellular Carcinoma Patients
Journal Title: Journal of Medical Science And clinical Research - Year 2015, Vol 3, Issue 11
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-tomoderately 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 agematched apparent healthy individuals as a control group. The median value of both serum AFP-L3 and AFPL3/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.
Authors and Affiliations
Dr Ayman Mohamed Abdou Shamseya
Keywords
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