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.
