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Because hepatocellular carcinoma (HCC) is a complex disease with multiple risk pathogenic mechanisms due to misdiagnosis with a single biomarker. A combination of biomarkers may be more valuable for the diagnosis, staging and prognosis of HCC. In the near future, identifying non-invasive and cost-effective biomarkers for early diagnosis and personalized treatment of HCC will be one of the most promising fields of biomarker research. This study assessed the alpha L fucosidase (AFU) value as a prognostic biomarker in patients with HCC before and after chemo-embolization and radio-frequency. A total of 60 subjects were subdivided into 3 groups: GI: 30 HCC patients underwent interventional management (chemo-embolization or radiofrequency), GII: 20 liver cirrhosis (LC) patients and GIII: 10 cross-matched individuals as controlThe results showed that plasma AFU had significantly higher diagnostic performance in HCC diagnosis than alpha fetoprotein (AFP) at a cut off value of > 2.5u/l, with sensitivity 100%, specificity 95%, positive predictive value (PPV) 96.8%, negative predictive value (NPV) 100% and diagnostic accuracy 98%. Basal pre-intervention AFU) had significantly high diagnostic performance to predict HCC recurrence after intervention at a cut off value of > 12.5u/l with sensitivity 100%, specificity 92%, PPV, 71.4%, NPV 100% and diagnostic accuracy 93.3%. Postintervention AFU had significant moderate diagnostic performance in predicting recurrence of HCC at cut off value of > 7.5u/l with sensitivity 80%, specificity 92%, positive predictive value (PPV) 66.7%, negative predictive value (NPV) 95.8% & diagnostic accuracy 90%.

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Background and aim Mac-2-binding protein glycosylation isomer (M2BPGi) is a novel serum diagnostic marker for liver fibrosis in various liver diseases. We aimed to evaluate its role in assessment of liver fibrosis in chronic hepatitis B infection (CHB) with reference to liver stiffness measurement (LSM) by transient elastography (Fibroscan). Design and Methods A case control study. 50 CHB patients with LSM by transient elastography technology and retrievable serum samples and 20 normal volunteers as a control group were recruited. Results 50 CHB patients (M: F = 30:20; mean age 43years ± 10.58) and 20 normal control volunteers (M: F = 12:8; mean age 37years ± 14.5) were recruited. The mean M2BPGi values for control group, F0-F1, F2, F3 and F4 progressively increased with more advanced stages of liver fibrosis: 0.282, 0.719, 1.322, 1.65 and 1.904 COI, respectively (p < 0.001). M2BPGi levels correlated well with liver stiffness (r = 0.911) and moderately with FIB-4 (r = 0.682), and with APRI (r = 0.536) (all p < 0.001). Using cut-off values of 0.455, 1.02, 1.16, 1.66 and 1.71COI for control, F0-F1, F2, F3 and F4 groups, respectively, the AUROCs were 0.996, 0.996, 0.691, 0.794 and 1.00 for control, F0-F1, F2, F3 and F4 groups, respectively. There was a statistically significant but with weak positive correlation between M2BPGi serum level and INR (r = 0.333, p = 0.018). And there was a statistically significant but with weak negative correlation between M2BPGi serum level and platelet count (r = -0.41, p = 0.003) and HBV DNA (r = -0.373, p = 0.008).There was a statistically significance between M2BPGi serum level and the history of varices (p = 0.023) Conclusions WFA+-M2BP is an accurate serum indicator for assessing different stages of liver fibrosis. WFA+-M2BP provides a simple and reliable alternative or complementary method to liver biopsy and FibroScan.