scholarly journals Role of annexin A2 and osteopontin for early diagnosis of hepatocellular carcinoma in hepatitis C virus patients

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Abd El-Fattah F. Hanno ◽  
Fatma M. Abd El-Aziz ◽  
Akram A. Deghady ◽  
Ehab H. El-Kholy ◽  
Aborawy I. Aborawy

Abstract Background Liver cancer is the fifth most common cancer and the second most frequent cause of cancer-related death globally. Early stages of hepatocellular carcinoma (0&A) can be treated with curative procedures. The aim of this work was to evaluate the role of annexin A2 and osteopontin for early diagnosis of hepatocellular carcinoma in hepatitis C virus patients. Methods The study was carried out on 80 patients classified into two groups. Group A had 40 chronic hepatitis C patients without hepatocellular carcinoma, while group B had 40 chronic hepatitis C patients with early hepatocellular carcinoma (stages; 0&A). All patients were subjected to thorough history taking, clinical examination, liver function tests, renal function tests, serum alpha-fetoprotein, serum osteopontin, and serum annexin A2. Results Serum alpha-fetoprotein was found to be statistically significantly higher in patients with the hepatocellular carcinoma group than the chronic hepatitis C group. The ROC curve for alpha-fetoprotein for detection of HCC was significant, its diagnostic performance was 0.818* (p < 0.001*), and the cutoff point for predicting the probability for HCC was 6.0 (ng/ml) with sensitivity of 77.50%, specificity of 82.50%, positive predictive value of 81.60%, negative predictive value of 78.6%, and accuracy of 80%. Serum osteopontin was found to be statistically significantly higher in patients from the hepatocellular carcinoma group than the chronic hepatitis C group. The ROC curve for osteopontin was significant, its diagnostic performance was 0.739* (p < 0.001*), the cutoff point was 13.2 (ng/ml) with sensitivity of 65.0%, specificity of 90.0%, positive predictive value of 86.70%, negative predictive value of 72.0%, and accuracy of 77.0%. Serum annexin A2 was found to be statistically significantly higher in patients from the hepatocellular carcinoma group than the chronic hepatitis C group. The ROC curve for annexin A2 was significant, its diagnostic performance was 0.927* (p < 0.001*), the cutoff point was 10.1(ng/ml) with sensitivity of 85.0%, specificity of 85.0%, positive predictive value of 85.0%, negative predictive value of 85.0%, and accuracy of 85.0%. Conclusions Osteopontin had better specificity but lower sensitivity than serum alpha-fetoprotein for early diagnosis of hepatocellular carcinoma. Annexin A2 had better diagnostic sensitivity and specificity than alpha-fetoprotein for early diagnosis of hepatocellular carcinoma.

2021 ◽  
Vol 71 (1) ◽  
pp. 12-17
Author(s):  
Laima Alam ◽  
Farrukh Saeed

Objective: To assess the non-invasive biomarkers of fibrosis for predicting varices-needing-treatment in patients with cirrhosis secondary to chronic-hepatitis-C. Study Design: Cross sectional comparative study. Place and Duration of Study: Department of Gastroenterology, Pak Emirates Military Hospital Rawalpindi, from Jan 2017 to Dec 2017. Methodology: A total of 153 patients aged 18-79 with cirrhosis, whether compensated or decompensated, secondary to chronic-hepatitis-C were enrolled. Relevant serum tests were used to calculate non-invasive fibrosis indices and their diagnostic performance to predict the presence of varices and varices-needing-treatment was calculated. Results: King’s score showed the best performance in detecting varices due to high positive predictive value of 96.4% and positive likelihood ratio of 2.4. Overall, all the non-invasive fibrosis indices exhibited good performance with positive predictive value >85% but none could rule out the presence of varices with adequate reliability due to low negative-predictive-value (<65%). King’s score exhibited relatively higher positive-predictivevalue (70%) and negative predictive value (51.1%) and the lowest negative-likelihood-ratio (0.6) for predicting varices needing treatment. Taken together, none of the non-invasive biomarkers of fibrosis could predict the presence of varices-needing-treatment with adequate accuracy due to low positive-predictive-value (<85%) andlow negative-predictive-value (<65%). Conclusion: The calculated non-invasive biomarkers of fibrosis and their optimum cutoff values showed modest accuracy for predicting varices and varices-needing-treatment. These indices may be used as first-line screening method for segregation of clinically significant portal hypertension and high risk esophageal varices-needingtreatment but may not be able to replace the gold standards like Fibroscan liver and Hepatic Venous Pressure Gradient measurements.


QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mohammed Abd Elfattah Elmalatawy ◽  
Khaled Zakaria Elqarmoty ◽  
Hany Samir Rasmy ◽  
Ebrahim Youssef Abdelwarth

Abstract Background Hepatitis c virus is global health burden and major health hazard in Egypt, since the virus is the etiological factor of chronic hepatitis that frequently progress to a cirrhosis and hepatocellular carcinoma (HCC). In addition to cirrhosis and hepatocellular carcinoma, HCV is thought to cause metabolic alterations, including steatosis, dyslipidemia, insulin resistance (IR), diabetes, obesity, and cardiovascular events. Objective To determine the value of RPB4 in the prediction of response to new DAAS treatment in chronic HCV infected patients and to correlate its level with the metabolic profile and fibrosis degree among chronic HCV Patients and Methods This study was Prospective cohort clinical study that was conducted at hepatology and virology outpatient clinic at Ain Shams University Hospital &Hepatology and virology outpatient clinic at Kafr –El Sheikh liver institute from January 2019 to October 2019 after informed consent. Results The present study showed that the best level of RBP4 in prediction of hepatic fibrosis stage 4 was ≤ 46 pg/ml and had sensitivity of 100% while the specificity was 66.67%.The positive predictive value was 50%while the negative predictive value was 100% and test accuracy was 80.5%. Conclusion Serum RBP4 was found to be higher in chronic hepatitis C naïve patients than normal person; there was significant reduction of RBP4 post treatment. Fibroscan showed marked reduction of fibrosis degree after treatment with Directly acting antiviral in both cirrhotic and noncirrhotic patients regardless the treatment regimen used with improved overall liver function tests, liver enzymes and platelet count in patients who reached SVR and maintained negative PCR after treatment.


2000 ◽  
Vol 118 (4) ◽  
pp. A1453
Author(s):  
Sumodh C. Kalathil ◽  
David D. Douglas ◽  
Edwyn M. Harrison ◽  
Monte L. Anderson ◽  
Joseph G. Hentz ◽  
...  

2014 ◽  
Vol 67 (suppl. 2) ◽  
pp. 31-38
Author(s):  
Maja Ruzic ◽  
Milotka Fabri ◽  
Tomislav Preveden ◽  
Sanja Stojanovic ◽  
Zoran Milosevic ◽  
...  

Introduction. The incidence of chronic hepatitis C and its consequences, liver cirrhosis and hepatocellular carcinoma is growing rapidly. The aim of this study was to evaluate clinical characteristics of patients with hepatocellular carcinoma and chronic hepatitis C treated at the Clinical Centre of Vojvodina and therapy options. Material and Methods. This retrospective study included 51 patients (52.9% male and 47.1% female) with chronic hepatitis C and hepatocellular carcinoma treated between 2000 and 2014. The average age of patients was 61.6 years (SD=10.8) and the average duration of hepatitis C virus infection was 30.2 years (SD=11.7). All patients had liver cirrhosis and 43.1% had previously been treated with pegylated interferon and ribavirin. According to the Barcelona Clinic Liver Cancer criteria, stadium A, B, C and D were found in 15.7%, 52.3%, 19.6% and 11.8% of the patients, respectively. The average value of alpha fetoprotein at the moment of making diagnosis of hepatocellular carcinoma was 397.56 ng/ml and the level of alpha fetoprotein was below 20mg/ml in 26% of patients. Tumor resection, radiofrequency ablation, chemoembolization, systemic chemotherapy and liver transplantation were performed in 13.7%, 3.9%, 1.9%, 1.9% and 5.9% of patients, respectively. Average survival time after the diagnosis of hepatocellular carcinoma among patients included in the study was 1.39 (SD=1.61) years. Conclusion. Ultrasound examinations of the patients with liver cirrhosis caused by hepatitis C virus infection are obligatory every 3 months. Etiology of every focal lesion in the liver must be clarified, which could increase the possibility of administration of available therapeutic methods.


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