Role of glypican-3 in the early diagnosis of hepatocellular carcinoma among Egyptian patients

Abstract

The aim was evaluation of the role of glypican-3 (GPC3) in early diagnosis of hepatocellular carcinoma (HCC) among Egyptian patients associated with hepatitis C virus (HCV) where genotype 4a is prevalent, as well as differentiating HCC from benign chronic liver disease.Methods: 80 individuals were enrolled in the study: 14 healthy volunteers, 18 patients with HCV, 18 patients with liver cirrhosis (LC) and 30 patients with HCC. Serum GPC3 and AFP levels were measured using ELISA technique.Results: GPC3 at cut-off value of 3.8 ng/ml (100% specificity) have superior sensitivity than AFP at cut-off values of 151.0 ng/ml (100% specificity) in differentiating HCC from benign liver disease. The GPC3 sensitivity was 93.3% versus 83.3% for AFP while the combined use of both markers improved the sensitivity to 96.7%. For early detection of HCC with tumor size P5 cm, the GPC3 sensitivity was 93.8% versus 87.5% for AFP while the combined use of both markers improved the sensitivity to 100%. Also early detection of uninodular HCC, the GPC3 sensitivity was 92.3% versus 84.6% for AFP while the combined use of both markers improved the sensitivity to 100%.Conclusion: Serum GPC3 could be a potential serum marker due to its high sensitivity and specificity in early detection of HCC. The combined use of both serum GPC3 and AFP provides a promising battery of tumor markers for differentiation of HCC from benign chronic liver diseases and early detection of small and uninodular HCC.

Development of a Clinical Chemiluminescent Immunoassay for Serum GPC3 and Simultaneous Measurements Alone With AFP and CK19 in Diagnosis of Hepatocellular Carcinoma

“…The positive expression rates in HCC tissues can reach 70–90% and 40–60% in serum, with the specificity more than 90%. GPC3 may have a better utility value in detecting small and early HCC than AFP . The combined use of serum GPC3 and AFP can significantly increase the sensitivity of the diagnosis up to 80% since there may be an approximately 40% rate of GPC3‐positive but AFP‐negative diagnosis .…”

GPC-HCC model: a combination of glybican-3 with other routine parameters improves the diagnostic efficacy in hepatocellular carcinoma

“…However, on univariate analysis, the baseline levels of many candidate markers were associated with the HCC risk. Multivariate regression analysis revealed that only albumin, GPC3, AFP, and total bilirubin retained significance a Similar GPC3 were previously used [16,17] and this cutoff was obtained by the ROC curve analysis b AFP cutoff exactly as originally described [18] c GPC-HCC model = 0.517 + 0.018 × GPC3 (ng/ml) + 0.108 × logAFP (U/L) + 0.025 × total bilirubin (mg%) -0.233 × albumin (g/dl) when combined with each other. This finding and the ROC curve analysis proved that these blood markers are independent predictive variables for HCC.…”

“…Interestingly, the ROC analysis shows that the optimum model diagnostic cutoff value for HCC versus non-HCC was zero. The optimum cutoff for GPC3 was 6 ng/ml, and the similar small cutoff values were previously used [16,17], while it was 400 U/L for AFP, exactly as originally described [18]. The model AUC values for HCC versus liver fibrosis, cirrhosis, and all non-HCCs (fibrosis and cirrhosis combined) were 0.971, 0.905, and 0.939, respectively (Fig.…”

Role of Serum Glypican-3 in the Diagnosis of Hepatocellular Carcinoma in the Upper Egypt

“…In a previous study by Zakhary et al, 2012 [29], among Egyptian patients with HCC on top of CHC, the sensitivity and specificity of AFP for differentiating Open Journal of Gastroenterology Figure 1. ROC curve analysis shows higher AUROC of GPC3 for prediction of HCC than that of AFP (0.92 vs 0.78).…”