Predictive Value of Biomarkers Fibrinogen Like Protein-2 and A-Fetoprotein for Hepatocellular Carcinoma Among Patients with Liver Cirrhosis

Abstract

1.1. Aim: Data concerning the utility of biomarkers for accurate early HCC detection in cirrhotic patients are lacking. Methods:We evaluated 112 consecutive Caucasian cirrhotic patients with (n=28) or without (n=84) concomitant HCC at baseline for serum AFP and plasma fibrinogen like protein-2 (FGL-2) levels. Patients without confirmed HCC at baseline were further followed up every six months with ultrasound and serum AFP levels, according to HCC surveillance program. Imaging as well as histological confirmation of HCC was established in patients with new lesions. During 5-year surveillance, 14 (16.6%) patients developed HCC. Results:Mean plasma FGL-2 levels were 4.04±3.80 pg/ml in the whole population but were significantly higher in patients with CP-B/C cirrhosis compared to those with CP-A (p<0.0001) as well as in patients with HCC compared to those without (p=0.001). Patients who finally developed HCC had significantly lower platelet count (p=0.008), higher FGL-2 levels (p=0.01) and were frequently categorized as CP-B/C stage (p=0.006) compared to those who did not. In the multivariate analysis, male gender (OR=20.801, p=0.024), platelets (OR=0.980, p=0.025) and CP score (CP-B/C vs A, OR=27.184, p=0.004), but not FGL-2 or AFP levels, were significantly correlated with HCC appearance. Conclusion:Plasma FGL-2 levels are significantly elevated in cirrhotic patients with decompensated liver disease compared to those with compensated cirrhosis and presence of HCC as well as HCC staging, seem to further influence them. Liver disease severity as well as low platelet count, but not baseline FGL-2 or AFP levels, could predict HCC emergence among Caucasian cirrhotic patients.