Ahmed M Tahon1, Magdy Z El-Ghanam2, Samy Zaky3, Tarek Mostafa Emran2, Ali M Bersy2, Fathiya El-Raey3, Elsayed A Z4,5, Amr M El Kharsawy2, Dina Johar6,7. 1. Department of Clinical Pathology, Faculty of Medicine, Al-Azhar University, Nasr City, Cairo, Egypt. 2. Department of Clinical Pathology, Faculty of Medicine, Al-Azhar University, Damietta, Egypt. 3. Department of Tropical Medicine, Faculty of Medicine, Al-Azhar University, Nasr City, Cairo, Egypt. 4. Faculty of Sciences, Jouf University, Jouf, Kingdom of Saudi Arabia. 5. Zoology Department, Faculty of Sciences, Al-Azhar University, Nasr City, Cairo, Egypt. 6. Department of Biochemistry and Nutrition, Faculty of Women for Arts, Sciences and Education, Ain Shams University, Heliopolis, Cairo, Egypt. dinajohar@gmail.com. 7. Department of Physiology and Pathophysiology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada. dinajohar@gmail.com.
Abstract
BACKGROUND: Egypt has high incidence of hepatocellular carcinoma (HCC). This is due to wide spread of hepatitis C virus (HCV) infection which is responsible for most of the cases of liver cirrhosis. The major diagnostic techniques for HCC include serum markers and various imaging modalities. Glypican 3 (GPC3) protein is highly expressed in HCC, but not in normal liver tissue. The significance of GPC3 as a predictor or diagnostic tool for human tumors other than HCC is unclear. AIM: To quantitatively assess the role of GPC3 in diagnosis of HCC in comparison to α-fetoprotein (AFP), ultrasonography (US), and computerized tomography (CT). PATIENTS AND METHODS: This cross-sectional study enrolled 85 subjects: 40 cirrhotic patients with primary HCC, 30 cirrhotic patients without HCC, and 15 healthy individuals. All patients were recruited from the Gastroenterology and Tropical Departments and outpatient clinics of New Damietta Hospital during the period from November 2010 to August 2012. RESULTS: GPC3 is positive in some HCC patients with normal levels of AFP. AFP has lower sensitivity (67.5%) compared to higher sensitivity of GPC3 (82.5%), and near specificity (61.2%) to GPC3 (57.8%). CONCLUSION AND SIGNIFICANCE: The combined serum AFP and GPC3 significantly increased the sensitivity of HCC diagnosis. Although GPC3 is better than AFP in diagnosis of HCC, it still lacks the 100% sensitivity and specificity because some patients have negative or normal level of GPC3 (below the cutoff point 1.5 ng/ml) despite being diagnosed by triphasic CT.
BACKGROUND: Egypt has high incidence of hepatocellular carcinoma (HCC). This is due to wide spread of hepatitis C virus (HCV) infection which is responsible for most of the cases of liver cirrhosis. The major diagnostic techniques for HCC include serum markers and various imaging modalities. Glypican 3 (GPC3) protein is highly expressed in HCC, but not in normal liver tissue. The significance of GPC3 as a predictor or diagnostic tool for humantumors other than HCC is unclear. AIM: To quantitatively assess the role of GPC3 in diagnosis of HCC in comparison to α-fetoprotein (AFP), ultrasonography (US), and computerized tomography (CT). PATIENTS AND METHODS: This cross-sectional study enrolled 85 subjects: 40 cirrhotic patients with primary HCC, 30 cirrhotic patients without HCC, and 15 healthy individuals. All patients were recruited from the Gastroenterology and Tropical Departments and outpatient clinics of New Damietta Hospital during the period from November 2010 to August 2012. RESULTS:GPC3 is positive in some HCC patients with normal levels of AFP. AFP has lower sensitivity (67.5%) compared to higher sensitivity of GPC3 (82.5%), and near specificity (61.2%) to GPC3 (57.8%). CONCLUSION AND SIGNIFICANCE: The combined serum AFP and GPC3 significantly increased the sensitivity of HCC diagnosis. Although GPC3 is better than AFP in diagnosis of HCC, it still lacks the 100% sensitivity and specificity because some patients have negative or normal level of GPC3 (below the cutoff point 1.5 ng/ml) despite being diagnosed by triphasic CT.
Authors: Young Kwan Sung; Sun Young Hwang; Mi Kyung Park; Mohammad Farooq; In Sook Han; Han Ik Bae; Jung-Chul Kim; Moonkyu Kim Journal: Cancer Sci Date: 2003-03 Impact factor: 6.716