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أستاذ
Combined Serum Levels of DCP and AFP-L3% for Assessment of Pathological Invasion of Hepatocellular carcinoma
• 2011
معلومات البحث
المؤلفون
Ali Hasaneen MD, Ibrahim h. Alattar MD* & Jehan H. Sabry MD**
الكلمات المفتاحية
Not Available
المجلة العلمية
Not Available
الناشر
Not Available
المجلد
Not Available
العدد
Not Available
الصفحات
Not Available
publication.type
International
رابط البحث
Not Available
المواد المرفقة
Not Available
الملخص
Objectives: To evaluate the value of estimating serum Des-γ-carboxyprothrombin (DCP), lens culinaris agglutinin-reactive alpha-fetoprotein (AFP) percentage of total AFP concentration (AFP-L3%) and/or total AFP as predictors for hepatocellular carcinoma (HCC) grades.
Patients & Methods: The study included 26 patients with HCC and 20 controls. All patients underwent complete clinical examination, radiologic and laboratory assessment. Blind liver biopsies were done for histopathological examination and grading. A fasting blood samples were obtained from all patients and controls for ELISA estimation of DCP and liquid-phase binding assay for AFP and AFP-L3% serum levels.
Results: Liver biopsy histopathological grading of HCC defined 13 patients with well differentiated, 7 with moderately differentiated, and 6 with poorly differentiated HCC. Serum levels of the three parameters were significantly higher in patients compared to controls, and in patients had poorly compared to patients had well differentiated HCC; on the other hand, the serum levels of DCP and AFP-L3% were significantly higher in patients had poorly compared to those had moderately differentiated HCC, whereas, the serum DCP levels were significantly higher, but the serum AFP and AFP-L3% levels were non-significantly higher, in patients had moderately differentiated HCC compared to those had well differentiated HCC. Stepwise regression analysis defined serum DCP levels, alone or in combination with other markers, as a significant predictor for the extent of pathological advancement in three models of statistical analyses, and the ROC curve analysis supported its specificity followed by AFP-L3% with significant difference compared to the null hypothesis, while AFP alone was non-significant as specific marker.
Conclusion: A panel of DCP and AFP-L3% provided a high diagnostic yield for the presence of HCC as well as for the prediction of its pathological grading, and thus could be used in conjunction with other non-invasive diagnostic modalities to avoid unnecessary liver biopsies, especially in compromised or early staged patients.
Patients & Methods: The study included 26 patients with HCC and 20 controls. All patients underwent complete clinical examination, radiologic and laboratory assessment. Blind liver biopsies were done for histopathological examination and grading. A fasting blood samples were obtained from all patients and controls for ELISA estimation of DCP and liquid-phase binding assay for AFP and AFP-L3% serum levels.
Results: Liver biopsy histopathological grading of HCC defined 13 patients with well differentiated, 7 with moderately differentiated, and 6 with poorly differentiated HCC. Serum levels of the three parameters were significantly higher in patients compared to controls, and in patients had poorly compared to patients had well differentiated HCC; on the other hand, the serum levels of DCP and AFP-L3% were significantly higher in patients had poorly compared to those had moderately differentiated HCC, whereas, the serum DCP levels were significantly higher, but the serum AFP and AFP-L3% levels were non-significantly higher, in patients had moderately differentiated HCC compared to those had well differentiated HCC. Stepwise regression analysis defined serum DCP levels, alone or in combination with other markers, as a significant predictor for the extent of pathological advancement in three models of statistical analyses, and the ROC curve analysis supported its specificity followed by AFP-L3% with significant difference compared to the null hypothesis, while AFP alone was non-significant as specific marker.
Conclusion: A panel of DCP and AFP-L3% provided a high diagnostic yield for the presence of HCC as well as for the prediction of its pathological grading, and thus could be used in conjunction with other non-invasive diagnostic modalities to avoid unnecessary liver biopsies, especially in compromised or early staged patients.