Evaluating the Serum Markers for Early Diagnosis of HCV Induced Hepatocellular Carcinoma

Abstract

Hepatocellular carcinoma is a global public health problem which is intensified at developing countries due to lack of early diagnosis. Since Hepatitis C virus related morbidity accounts five million people in Pakistan, rate of morbidity and mortality of HCV related Hepatocellular carcinoma infections is high in Pakistan, and it is attributed to its diagnosis after its development. The public has the lack of awareness about the importance and benefits of liver biopsy testing; therefore, improved, and non-invasive methods of HCC diagnosis are urgently needed. The aim of the present study was to evaluate the importance of serum markers in early diagnosis of HCV induced Hepatocellular carcinoma and to develop a robust set of serological markers for their early detection and diagnosis. A total of 60 HCV positive patients including Chronic Liver disease (n=20), Cirrhosis (n=20), HCC patients (n=20) and 20 healthy volunteers (n=20) were enrolled in this study after an extensive screening process. Blood samples were collected from all the subjects and processed for serum separation followed by immunological, molecular, and biochemical analysis using Enzyme Linked Immunosorbant Assay, Real-Time PCR, complete blood picture, and a range of biochemical tests. Results showed gender wise variability among the subjects from each of the study groups where in the male subjects remained dominant with male and female ratio as 61.75:38.75. The average age of male subjects was observed between 42y, 43y, 49y and 37 years in comparison of female subjects who were 46y, 53y, 50y and 47y in CLD, cirrhosis, Hepatocellular carcinoma, and control groups, respectively. The data has also demonstrated that Hepatocellular carcinoma patients having Alpha Fetoprotein level >1000 showed the increased level of ALP and GGT with decreased HB and HCT. However, the Hepatocellular carcinoma patients having AFP level in the range of 100-500 had total bilirubin level > 3.0, while those having AFP level <100 has all serological markers in normal range. In addition, the patients of HCC showed increased PT with decreased albumin level. The increases level of albumin level (>3-<4.0) was observed from the serum samples of cirrhosis and Chronic liver disease patients. The increase in albumin up to 4.0 accompanied with the increased level of ALP and PT while decreased HB. In conclusion, different biochemical parameters may be used to distinguish the patients having Hepatocellular carcinoma from those suffering from cirrhosis and chronic liver disease induced by HCV infection. The findings of present study may help to enhance the outcome for patients with HCC by enabling the diagnosis to be made at an earlier stage of the disease.