Diagnostic Value of Glypican 3 as a Marker of Hepatocellular Carcinoma in Egyptian Cirrhotic Patients

Abstract

Abstract Background Hepatocellular carcinoma (HCC) is the sixth most common cancer and the third cause of cancer-related mortality world-wide. Early detection improves survival, and several HCC biomarkers have been studied for this purpose. However, aside from alpha- fetoprotein (AFP), none have entered broad clinical use globally. Aim of the Work to assess the diagnostic value of Glypican 3 as a marker of hepatocellular carcinoma in Egyptian cirrhotic patient. Patients and Methods This study is a comparative case control study. The period of the study is a 6th months. Post viral cirrhotic Egyptian patients treated in Ain Shams University hospitals. The study will be conducted on 60 Egyptian Cirrhotic patients with HBV OR HCV infection with or without HCC treated in Ain Shams University Hospitals Results In our study, The AFP level was significantly higher in high group [1700 (1122 – 5200)] than low group [700 (100 – 855)] and also significantly higher in both low and high groups than control group [2.6 (1.7 – 3.6)] and cirrhotic group [3.4 (1.5 – 5.8)] with p-value <0.001 and with no difference between cirrhotic and control. Regarding serum Glypican 3 which is the new marker addressed in this study, show that The GP3 level was significantly higher in low group [6.4 (5.6 – 7.53)] and high group [6.21 (5.16 – 7.98)] than control group [1.38 (1.22 – 1.54)] and cirrhotic group [1.65 (1.22 – 6.18)] with p-value <0.001 and with no difference between cirrhotic and control. In our study, there was statistically significant positive correlation found between GP3 level, total and direct bilirubin with (p value 0.004, 0.001) which is agreed with many studies as A 2,416 patient HCC cohort was studied and dichotomized into normal and abnormal plasma bilirubin groups. Their HCC characteristics were compared for tumor aggressiveness features, namely blood AFP levels, tumor size, presence of PVT and tumor multifocality. Conclusion Serum Glypican 3 level was significantly higher in patients with HCC regardless of other characteristics as presence of combined conditions as DM and HTN or Viral markers and mildly elevated in patients with liver cirrhosis compared to HCC group. Using of Glypican 3 will improve the diagnostic field and can help in early detection of HCC in surveillance programs Together with AFP. Glypican 3 can be used as prognostic factor and predictor of mortality from oesphogeal bleeding in patients with HCC