Serum Glypican-3 versus Alpha-fetoprotein in Patients with Hepatocellular Carcinoma on Top of HCV Related Liver Cirrhosis

Abstract

Background: Globally, hepatocellular carcinoma (HCC) is ranked as the fourth most frequent cause of death from cancer. The creation of more precise and sensitive blood markers, like Glypican-3 (GPC-3), for the early identification of HCC may improve patient survival. So we aimed to compare the clinical significance of serum GPC-3 levels with AFP in the diagnosis of HCC on top of HCV-related liver cirrhosis. Methods: A case-control study was performed in Hepatology and Gastroenterology unit of Internal Medicine Department, Zagazig University Hospitals. Ninety subjects were divided into: Group I: proved HCC patients. Group II: liver cirrhotic patients. Group III: Normal. All participants underwent GPC-3 assessment. Results: Alpha fetoprotein (AFP) was superior on serum Glypican-3 in diagnosis of liver cirrhosis, whereas the best cutoff was (≥19.5 Vs. ≥2.25), AUC (0.945 vs. 0.859), sensitivity (93.3% vs. 83.3%), specificity (76.7% vs. 70 %), PPV (80% vs. 73.5 %), NPV (92% vs. 80.8 %), and overall accuracy (85% vs. 76.7 %) respectively. In diagnosis of HCC, Glypican-3 was superior on AFP, whereas the best cutoff of AFP vs. serum Glypican-3 was (≥32.5 Vs. ≥3.65), AUC (0.858 vs. 0.873), sensitivity (80% vs. 90%), specificity (75% vs. 76.7 %), PPV (61.5% vs. 65.9 %), NPV (88.2% vs. 93.9 %), and overall accuracy (76.7% vs. 81.1 %) respectively. Conclusion: Serum AFP alone has a low diagnostic power in diagnosing HCC. On other hand, serum GLP-3 has great sensitivity and specificity in early detection of HCC.