الفهرس 
INTRODUCTION,EPIDEMIOLOGY, DIAGNOSIS AND TREATMENT OF HEPATO-CELLULAR CARCINOMAOnly 14 pages are availabe for public view
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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. AFP
was the only tumour marker that is used for early diagnosis of HCC.
However, it was found that it is associated with false positive and false
negative results. So,there was a great demand by clinicians to find new
HCC specific tumour markers. AFP-L3 is the major glycoform found
in individuals with HCC.
Aim : The aim of this study was to determine serum AFP-L3 in HCC
patients, estimate the ratio of AFP-L3 to total AFP and to correlate the
AFP-L3% with the tumour burden.
Methods:This study was performed on 64 patients; 47 patients had HCC
and 17 patients had liver cirrhosis. Both groups were subjected to
history taking, clinical examination, routine laboratory evaluation, serum
AFP, serum AFP-L3 ultrasound examination and disease severity
assessment by Child-Pugh classification, MELD score, BCLC score.
Results: We found that, mean values of AFP-L3 were higher in HCC
patients as compared to cirrhosis patients . There was a significant
relation between AFP and AFP-L3% at cutoff value of 5% and 10% in
patients with AFP (10-200ng/ml). AFP was significantly higher among
HCC patients when compared to cirrhosis patients. There was a non
significant relation between AFP-L3% and age of patients,biochemical lab results, the number ,the diameter of the hepatic focal lesions, Child-
Pugh, MELD and BCLC scores.The best cutoff value for AFP in this
study was 62.5ng/ml which yielded a sensitivity, a specificity, PPV,
NPV of 79%, 47%, 80% and 44.4% respectively.There was a significant
positive relation between AFP and the diameter of the tumour
foci.However,a non significant relation with number of tumour
foci,BCLC staging and Child Pugh and MELD scores.
Conclusion: The target population for AFP-L3% might be those chronic
liver disease patients who have AFP concenterations in the intermediate
range of 10-200ng/ml and a small or intermediate mass on imaging.