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Abstract
Hepatocellular carcinoma (HCC) is one of the most common
malignancies worldwide and it is one of the major causes of death, because of
its high frequency and poor prognosis. HCC is now a rather common
malignancy in Egypt which usually develops on top of liver cirrhosis
secondary to viral infection.
The aim of this study was to investigate the potential role of
Chromogranin-A (Cg-A) as a diagnostic non invasive marker in HCC
patients with or without Alpha-fetoprotein (AFP) elevation in order to add a
diagnostic beneficial value in patients with low levels of AFP and suspected
to have HCC.
This study was conducted on 60 cirrhotic patients, 30 of them
documented HCC using Triphasic CT and histopathological assessment and
30 with no evidence of HCC; as well as 30 normal healthy subjects serving as
control group.
We determined the level of AFP, Cg-A for all cases together with
history taking, clinical examination, liver biochemical profile, viral markers,
conventional US, abdominal Triphasic CT and guided liver biopsy for HCC
cases with atypical CT pattern.
We concluded that the diagnostic sensitivity of AFP at a cutoff 200
ng/ml was 32.2% and the specificity 100%. The cutoff level of Cg-A for
diagnosis of HCC in this study was 16.75 nmol/l, with a sensitivity and
specificity 66.7% and 80% respectively. Serum Cg-A was significantly
elevated in the HCC group having focal hepatic lesions >2 cm in diameter
when compared to those lesions <2 cm. The combined use of the two markers
(AFP and Cg-A) led to increase the sensitivity of AFP from 60% to 93.3%.
This showed that simultaneous measurements of serum AFP and Cg-A for
detecting HCC may give the highest index of detection.