Clinical Value of Fetuin A in Cirrhosis Associated Hepatocellular Carcinoma
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- Category: Vol. 82, December 2014
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Clinical Value of Fetuin A in Cirrhosis Associated Hepatocellular Carcinoma, YASSER A. ELNAGGAR, HALA I.M. HUSSEIN and HODA A. IBRAHEEM
Abstract
Introduction and Aim of the Work: Biochemical and molecular markers of hepatocellular carcinoma and their clinical utility are an important research issue, fetuin A is a negative acute phase protein known to be down regulated in infection, inflammation and malignancy. In this study we aimed to determine its discriminating value for HCC and its clinical value.
Patients and Methods: Thirty patients with HCC, 20 patients with liver cirrhosis, 20 patients with chronic hepatitis and 20 healthy controls were enrolled in study. The diagnosis of HCC patients was based on triphasic computed tomography. Estimation of serum fetuin A was done by enzyme linked immunosorbent assay.
Results: Serum Fetuin A levels showed significantly progressive decrease along patients groups from chronic hepatitis to HCC (p<0.001). HCC patients had the lowest significant level of serum Fetuin A levels when compared to other groups. Also, serum AFP levels showed statistically significant increase among the studied groups. As regard the discriminating value of the studied markers for HCC from cirrhosis, serum Fetuin A had area under curve (AUC) 0.87 (CI: 0.77-0.97), while, AUC of AFP was 0.84 (CI: 0.73-0.95). At cutoff value 337ug/ml, decreased serum Fetuin A showed 75% sensitivity and 86.7% specificity, positive predictive value (PPV) 88.5%, and negative predictive value (NPV) 70.8%. While at cutoff value 200ng/ml, increased AFP showed 60% sensitivity and 75% specificity, PPV 78.3% and NPV 55.6%, Table (3). Combination of both markers yielded 90% sensitivity and 95% specificity, PPV 96.4% and NPV 86.4%. Serum Fetuin A levels had statistically significant negative correlation with Child-Pugh score, while serum AFP levels had no statistically significant with Child-Pugh score.
Conclusion: We concluded that reduced serum fetuin A levels can detects the development of HCC in viral cirrhotic patients and its correlation to Child-Pugh score could be of clinical value in treatment decision making.