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Year : 2019  |  Volume : 31  |  Issue : 4  |  Page : 451-457

Noninvasive prediction of hepatitis C-associated hepatocellular carcinoma using circulating apolipoproteins

1 Department of Endemic Medicine and Hepatogastroenterology, Faculty of Medicine, Cairo University, Cairo, Egypt
2 Department of Medical Biochemistry, Faculty of Medicine, Cairo University, Cairo, Egypt
3 Department of Hepatogastroenterology, Egypt Air Hospital, Cairo, Egypt

Correspondence Address:
MD, GCSRT Heba Omar
Faculty of Medicine, Cairo University, Cairo, 11652
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ejim.ejim_26_19

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Background and aims Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related mortality worldwide. We investigated the potential usefulness of circulating apolipoproteins (Apo-A1 and Apo-A4) in HCC screening and diagnosis. Patients and methods We included 60 adult patients with hepatitis C virus-related chronic liver disease including HCC, in addition to 20 healthy controls. Patients were stratified into three equal groups, with 20 patients each: chronic hepatitis C, posthepatitis C cirrhosis (liver cirrhosis), and HCC. All patients and controls underwent full clinical assessment, laboratory investigations, and evaluation of candidate apolipoproteins by enzyme-linked immunoassay. Results Significantly higher Apo-A1 and Apo-A4 levels were detected in patients with HCC than in those with liver cirrhosis (P<0.001). Receiver operator characteristic curve showed that for HCC diagnosis, a cutoff of 78.6 mg/dl for Apo-A1 yielded 90% sensitivity and 100% specificity and a cutoff of 16.5 mg/dl for Apo-A4 yielded 85% sensitivity and 80% specificity. Furthermore, within HCC group, Apo-A1 was significantly higher in patients with small HCC (>2 cm) than those with large tumors (P=0.01). Lower Apo-A1 level correlated significantly with pylethrombosis (P=0.007). Conclusion Apo-A1 and Apo-A4 are novel biomarkers for HCC screening and diagnosis, with a special discriminative ability for Apo-A1 for those with small tumors and those with pylethrombosis.

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