Detection of Serum Biomarkers In Hepatocellular Carcinoma Patients

Abstract

Scientific background: HCC has increased significantly in the last decade, as the major risk factors are chronic infections with
hepatitis B and C viruses (HBV & HCV), other risk factors involve aflatoxin B1 exposure, pesticides, alcohol consumption, and
genetic defects. New serum tumor markers are required for the diagnosis of HCC instead of alpha-fetoprotein (the most widely
used marker) as it's diagnostic accuracy is poor.

Aim: To assess the diagnostic accuracy of serum AFP, AFP-L3, soluble Fas (sFas) and soluble Fas Ligand (sFasL) levels as biomarkers for the diagnosis of HCC. Subjects and Methods: 100 adult patients were selected for this study. Fifty (50) healthy
subjects, age and sex-matched, were considered as controls. Routine tests for liver cirrhosis & HCC were done. Serum sFas and
sFasL levels were measured using enzyme-linked immunosorbent assay. Results: Serum AFP, AFPL3, sFas, and sFasL levels were significantly elevated in HCC group when compared with other 2 groups. At a cut off level AFP ≥ 20 pg/ml, the sensitivity and specificity were 70 and 77 respectively. Serum sFas had sensitivity and specificity much better than AFPL3 in the diagnosis of HCC. Regarding serum sFasL level for diagnosis of HCC, it had 87% sensitivity, 84% specificity at a cut off level ≥ 17.5pg/ml.
Conclusions: The results of this present study clearly demonstrate that serum sFas and sFasL had a better sensitivity and specificity than AFP in differentiating patients with HCC from those with cirrhosis. s FasL could be used as the best reliable biomarkers in HCC resulting from chronic hepatitis C.