Study the Role of Cell Free DNA in the Diagnosis of Hepatocellular Carcinoma, an Egyptian Study

Abstract

Background and objective: Hepatocellular carcinoma (HCC) is a primary malignancy of the liver. Since the conventional tissue biopsy and AFP have limited value, a new promising diagnostic method” liquid biopsy” has emerged. Cell free DNA is one of the liquid biopsy corner stones along with circulating tumor cells. Aim of the work: The study aims to evaluate the role of cf-DNA in the prediction of HCC. Subjects and methods: Eighty newly diagnosed HCC cases and seventy seven apparently healthy individuals were recruited from the National Cancer Institute, Cairo University. Cf-DNA level is measured by Qubit fluorometer assay and AFP was measured by ELISA for control. Comparisons between quantitative variables were done using the non-parametric Kruskal-Wallisand Mann-Whitney. Correlation between quantitative variables were done using Spearman correlation coefficient and a ROC curve was constructed with area under curve analysis performed to detect best cut off value of cf-DNA and AFP for detection of HCC. Results: The median cf-DNA and AFP levels were statistically significant higher in HCC patients (0,11ng/µl and 160.9 ng/ml respectively) than in control group (0.04 ng/ µl and 1.30 ng/ml respectively). Upon plotting ROC curve, cf-DNA and AFP gave a sensitivity of 78% and 93.7% respectively, a specificity of 59.7% and 92.2% respectively. The diagnostic value of cf-DNA in combination with AFP level has slightly improved the specificity (96.1%) on the expense of the sensitivity which was decreased (69.5%). Conclusion: Cf-DNA plays a role in the prediction of HCC but still AFP has the upper hand in the diagnosis of HCC in Egyptian population. Liquid biopsy still hasits own limitations. The techniques of colleting’ liquid”, and detection of cf-DNA must be standardized.

Circulating MiRNA-373 as a Predictor of Response to Super-selective Transarterial Chemoembolization Bridging Therapy in Hepatocellular Carcinoma Patients Awaiting Liver Transplantation

“…Despite the significant improvement in the clinical staging systems, the integration of molecular data into these algorithms remains hypothetical according to the European Association for the Study of the Liver EASL (Peter R Galle, 2018). Molecular profiling of HCC allowed a better understanding of HCC pathophysiology and facilitated developing novel molecular targeted therapies for tumors previously considered as therapy-refractory (Radwan et al, 2022).…”

Frequency of Hepatitis B Markers in Systemic Lupus Erythematosus Patients in Iran

“…No data is available to validate the prevalence of HBV infection in the Khuzestan province. The persistence and replication of HBV in hepatocytes may result in wide spectrum of liver disease such as cirrhosis, fibrosis and hepatocellular carcinoma (Dandri and Petersen ,2016;Nour et al, 2022;Radwan et al, 2022). The frequency of HBV reactivation is estimated to be about 20% to 50% in HBV carriers undergoing immunosuppressive treatment and in some cases has led to fulminant or fatal hepatitis (Lok and McMahon, 2009;Huang et al, 2014;Chenet al, 2015).…”

Plasma Insulin/Erythrocytic Aldose Reductase Ratio as a Predictor for Hepatocellular Carcinoma among Type II Diabetics and Hepatitis C Virus-Iinfected Patients

“…Although ultra-sonography (US) and conventional tumor markers such as α-fetoprotein (AFP) are widely used for HCC detection, they still do not provide a satisfactory tool for early detection of HCC. Prediction of HCC is still on race, although recent trials showed that circulating cell free-DNA plays a role in the prediction of HCC despite the fact that AFP is still the commonest in the diagnosis of HCC (Radwan, 2022). As well as, its sensitivity in detecting small HCC (namely those below 1-2 cm) is rather low.…”