Serological Biomarkers of Hepatocellular Carcinoma in Egyptian Patients

Abstract

Abstract. Hepatocellular carcinoma (HCC) is one of the most aggressive cancers worldwide. In Egypt, the disease is usually detected in an advanced stage at which no treatment may be effective including surgery. Early detection of the disease is thus an important goal allowing the patient to be treated before the enlargement of the tumor or its metastasis to distant organs. Tumor markers are serological agents which serum level may be useful in predicting the presence of the tumor at early stages. Alpha fetoprotein (AFP) which is the golden marker for HCC is of low sensitivity, therefore, additional markers such as alpha-L-fucosidase (AFU), transforming growth factors alpha and beta (TGF-α and TGF-β) and interleukin-8 (IL-8) are suggested to be simultaneously evaluated in order to enhance the detection of HCC. A total of 96 patients with different liver diseases such as HCC, hepatitis C virus (HCV), hepatitis B virus (HBV) and cirrhotic patients are included in this study. Sixteen healthy volunteers are used as a control group. In patients with HCC each of AFP, AFU, TGF-α and TGF-β recorded significantly higher levels than the other patient groups and controls. HCC patients recorded significantly lower level of IL-8 compared to the other patient groups but significantly higher than the control. For AFP, AFU, TGF-α, TGF-β and IL-8, at the optimal cut-off values (obtained from the receiver operating characteristic (ROC) curves), the calculated sensitivities are 46%, 72.97%, 67.56%, 54.05% and 83.8%, respectively. The simultaneous evaluation using all of the suggested markers resulted in increasing the sensitivity up to 100%. It thus recommended that, if patients with cirrhosis, as high risk patients, are subjected to regular examination using these markers in addition to AFP, HCC may be detected by 100% sensitivity in an early stage and as a consequence an effective treatment can be achieved.

Annexin A2 as a biomarker for hepatocellular carcinoma in Egyptian patients

“…Our results revealed highly significant increases in the levels of AFP in patients with HCC compared with patients with CLD and subjects in the control group; this result was in agreement with that of El-Tayeh et al[27] and Awadallah et al[28]. They explained their results by an increase in the selective transcriptional activation of the AFP gene in malignant hepatocytes, which resulted in the increased secretion of AFP during the development of HCC.…”

Enhanced antiviral and antifibrotic effects of short hairpin RNAs targeting HBV and TGF-β in HBV-persistent mice

“…TGF-β plays critical roles not only in the progression of persistent HBV infection but also in the induction of liver fibrosis, cirrhosis, and HCC following HBV infection 34–36 . In our HBV-persistent mouse model, serum TGF-β expression increased by approximately 4-fold at 6 months after injection (Fig.…”

High Serum Transforming Growth Factor-β1 Levels Predict Outcome in Hepatocellular Carcinoma Patients Treated with Sorafenib

“…In clinical studies, blood TGF-b1 levels were higher in patients with HCC than in patients with chronic hepatitis or cirrhosis. Moreover, the serum TGF-b1 level in metastatic HCC was higher than that in localized HCC (16)(17)(18)(19).…”