الفهرس 
Hepatocellular CarcinomaOnly 14 pages are availabe for public view
 |  | from | 232 |  |  |
| | | from | 232 | | |
Abstract
ABSTRACT
HCC is the most common primary malignancy of the liver, being the fifth most frequent cancer worldwide. The incidence of HCC is on the increase and it is becoming more significant both clinically and epidemiologically.
This Study was A cross-sectional comparative study in Ain Shams University Hospitals for patients who attend Hepatology and virology outpatient clinic at Ain Shams University Hospital Also Liver transplantation department in Ain Shams specialized hospital.
This study had been carried out on 105 subjects, age range 39-68 years divided as the following group I includes 35 HCC patients diagnosed by imaging and alpha- fetoprotein, among the HCC patients there were 10 patients with portal vein invasion, group II includes 35 matched patients with liver fibrosis and cirrhosis only without HCC classified according to child score into child A , child B , child C .and group III includes 35 apparently healthy subjects, age and sex matched, having no acute or chronic illness and taking no medications were taken as control group.
In our study AFP, MPV and DCP were highest in HCC group, followed by CLD group and lowest in control group. The differences between all groups were significant in MPV and DCP, with no significant difference between CLD and HCC in AFP.
Our results also showed that regarding the diagnostic performance of the three tested tumor markers (AFP, MPV and DCP) in differentiating HCC from CLD groups that AFP had area under curve (AUC) of 0.719, Standard error (SE) of 0.061, Confidence interval (CI) of 0.599-0.839 and P value of 0.002 at a cut point of ≥40.0, MPV had area under curve (AUC) of 0.801, Standard error (SE) of 0.063, Confidence interval (CI) of 0.678−0.924 and P value of <0.001 at a cut point of ≥10.2, while DCP had area under curve (AUC) of 0.842, Standard error (SE) of 0.047, Confidence interval (CI) of 0.750−0.935 and P value of <0.001 at a cut point of ≥69.3 proving that DCP had the highest significant diagnostic performance in differentiating HCC from CLD groups also DCP≥ 69.3 had highest sensitivity(of 97.1%) and NPV(of 96.3%). AFP≥ 40.0 had highest specificity (of 91.4%) and PPV(of 86.4%). Youden‘s index
In detection of HCC testing AFP≥ 40.0 if positive considered positive. If negative, retest for DCP≥ 69.3 if positive considered positive, otherwise is negative. This although deceased specificity and Positive predictive value, it raised sensitivity and Negative Predictive Value to 100.0% when combining both AFP and DCP. The benefit of increasing the sensitivity is not to miss cases with HCC while the decreased specificity and PPV can be compensated by further imaging studies to eliminate the false positive cases.