Usefulness of acute phase proteins for monitoring development of hepatocellular carcinoma in hepatitis B virus carriers

Background: Serum levels of acute phase proteins (APP) have been used to diagnose and follow up treatment of liver diseases. This study was carried out to determine the usefulness of APP to predict development of hepatocellular carcinoma (HCC) among Hepatitis B virus (HBV) carriers. Study design: In a prospective study, serum haptoglobin, transferrin and alpha 2 macroglobulin levels of 55 subjects consisting of 20 HBV carriers, 18 HBV-positive HCC patients and 17 controls were determined using single radial immunodiffusion. Result: The mean levels of haptoglobin were 141.75mg/dl±133.76, 97.11mg/dl±92.62, 161.59mg/dl±146.86 for HBV carriers, HBV-positive HCC and controls respectively. The mean transferrin levels for HBV carriers, HBV-positive HCC and controls were 166.4mg/dl±88.31, 140.0mg/dl±68.73 and 270.35mg/dl±122.79 respectively while similar values for alpha 2 macroglobulin were 195.4mg/dl±93.86, 189.83mg/dl±77.19 and 127.53mg/dl±43.29. No significant difference in the mean serum haptoglobin levels of HBV carriers and HBV-positive HCC (p=0.526), HBV carriers and controls (p= 0.883) and HBV-positive HCC and controls (p=0.295). The difference between the mean serum transferrin levels was insignificant between HBV carriers and HBV-positive HCC, p=0.671, but was significant between HBV carriers, and HBV-positive HCC compared with controls, (p=0.005 and 0.000 respectively). No significant difference in alpha 2 macroglobulin between HBV carriers and HBV-positive HCC, (p=0.972), but the differences were significant between HBV carriers, and HBV-positive HCC and controls, (p=0.024 and 0.048 respectively). Conclusion: Haptoglobin, alpha 2 macroglobulin and transferrin lack predictive value for development of HCC in HBV carriers. Reduced transferrin and increased alpha 2 macroglobulin in HBV carriers might suggest active liver disease.