ObjectivesThe aim of this study was to assess serum levels of endocan & VEGF in patients with hepatitis C virus-related HCC and their diagnostic and predictive value of mortality.MethodsA total of 195 patients with CHC were subdivided into the following two groups: 105 HCV cirrhotic patients with HCC and 90 HCV cirrhotic patients without HCC. Sixty apparently healthy subjects served as the control group. The serum VEGF and endocan were assessed by ELISA.ResultsThe mean serum endocan level was 4257.6± 847.6 pg/mL in HCC patients, compared to 2099.2± 459.6 pg/mL in liver cirrhosis patients without HCC. VEGF levels in the HCC group were non-significantly higher than those of the non-HCC group, and control group. Endocan at cut-off value 2967 pg/ml had higher sensitivity and higher specificity in diagnosis of HCC than AFP and VEGF. The median follow up period was 9 months, survival curve analysis was done in HCC group and showed that probability of survival among HCC group with higher levels of VEGF and endocan were significantly lower than that patients with low levels. In HCC patients, elevated serum endocan levels were significantly associated with poor hepatic functions and a greater number and size of tumours. Multivariate analysis showed that serum endocan levels (≥4000 pg/ml), as well as elevated serum fetoprotein (>100 ng/dl), were independent prognostic biomarkers for mortality.ConclusionEndocan may be a useful diagnostic marker for HCC and a good predictor of mortality, especially when combined with AFP and VEGF.
Background and study aim: Von Willebrand factor (vWF) is released by activated endothelial cells and plays a crucial role in the development of portal hypertension. vWF levels correlate with liver function and venous hepatic pressure gradient (VHPG) and independently predict clinical outcome. The aim was to evaluate serum vWF levels as a predictor for esophageal varices and prognosis in patients with liver cirrhosis.Patients and Methods: Sixty two patients with liver cirrhosis, divided into two groups according to presence (group I) or absence (group II) of varices were included, In addition, twenty healthy persons served as control group (group III). All patients were submitted to full history taking, clinical examination, laboratory investigations and abdominal ultrasonography. The severity of liver disease was estimated by Modified Child-Pugh and Model for End Stage Liver Disease (MELD) scores. All patients were underwent upper gastrointestinal endoscopy and vWF assay.Results: vWF values were significantly higher in group I (p1=0.001), than controls (p2=0.000), but no significant difference between group II and control group (p3= 0.59). Receiver operating characteristics (ROC) curve analysis of vWF revealed that, vWF at cutoff value of 173.8 µg/ml; the sensitivity for detection of esophageal varices was 80.8%, specificity 76.0%, positive predictive value (PPV) was 93.9%, negative predictive value (NPV) was 55.6%; area under the curve was 86.6.There was significant positive correlation between vWF and Child, MELD, esophageal varices grade and severity of portal hypertensive gastropathy.
Conclusion:vWF is a good predictor for development of esophageal varices and correlated well with prognosis in patients with cirrhosis.
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