Frequency of Hepatocellular Carcinoma among Cirrhotic Patients with Hepatic Focal Lesion(s) and Low Serum Level of Alpha Fetoprotein
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- Category: Vol. 85, March 2017
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Frequency of Hepatocellular Carcinoma among Cirrhotic Patients with Hepatic Focal Lesion(s) and Low Serum Level of Alpha Fetoprotein, EMAN M. ABD EL-AAL, IBRAHIM M. IBRAHIM, NOHA E. SHAHEEN and SHERIF M. GALAL
Abstract
Background: Hepatocellular Carcinoma (HCC) is the most common primary malignancy of the liver and represents the third leading cause of cancer related deaths worldwide and one of the main causes of deaths in patients with liver cirrhosis. AFP is the commonest serologic marker of HCC although it has a low sensitivity for HCC.
Objectives: To determine the frequency of HCC among cirrhotic patients with hepatic focal lesion(s) and low AFP (<200ng/mL).
Patients and Methods: 180 cirrhotic patients with hepatic focal lesion(s) and low AFP (<200ng/mL) were included in the study. The nature of the hepatic focal lesion(s) is determined by triphasic CT scanning.
Results: Out of the 180 cirrhotic patients with hepatic focal lesion(s) and low AFP (<200ng/mL), 48 patients (26.7%) turned to have HCC. Other diagnoses included cirrhotic nodule(s), metastatic nodule(s) and hemangioma. At a cut off value of AFP 66ng/ml, the sensitivity was 75%, the specificity was 52.3, the positive predictive value was 85.2% and the area under the curve was 0.567.
Conclusions: Serum AFP alone is not a reliable indicator in detection of early and small HCC and can not be used to role out the diagnosis of HCC. New more sensitive biomarkers for the early detection of HCC are to be studied.