Evaluation of biomarkers for the detection of hepatocellular carcinoma in patients with hepatitis C virus

Objective: Hepatocellular carcinoma (HCC) is the most frequent and severe complication of chronic liver diseases. It represents an important public health problem in Egypt, where up to 90% of HCC cases are attributable to hepatitis C virus (HCV) infection. The objective of the present study was to assess a panel of biomarkers that can significantly differentiate between HCC and non-HCC patients with chronic HCV infection (CHC), quantitatively. Methods: A total of 75 adult male patients with CHC were divided into 3 main groups according to liver involvement: HCV without cirrhosis (CHC), patients with cirrhotic liver (LC), and HCC patients. Liver function, lipid profile, HBsAg, HCV antibodies, alpha-fetoprotein (AFP), insulin-like growth factor II (IGF-II), heparanase (HPSE), and lipid peroxidation were assayed. Results: The AST/ALT ratio, AFP, and HPSE were significantly different in the HCC group with the optimum cut-off values as ≥ 1.92, 64.7 ng/ml and 5.6 U/ml, respectively. By using these cut-off values combined; 96% of HCC patients showed two abnormal markers, corresponding to only 29% of the LC group. Conclusion: The use of combined HPSE, AFP and AST/ALT ratio cut-off values improved the positive predictive value for HCC from 79% to 96%. [J Exp Integr Med 2012; 2(4): 321-329]