Diagnostic Value of Glypican-3 for Hepatocellular Carcinomas

Abstract

Background: Hepatocellular carcinoma (HCC) is a common and dangerous malignancy in many parts of the world,<br />and especially in Egypt. Early diagnosis is the most important step in successful HCC management. However most<br />cases are detected at late stage making effective intervention impossible. Aim: The aim of this study was to evaluate<br />the potential of Glypican-3 (GPC-3) to aid in diagnosis of HCC, especially in patients with low serum alpha-fetoprotein<br />(AFP). Subjects and methods: Serum GPC-3 was assessed by flow-cytometry and serum AFP by enzyme-linked<br />immunosorbent assay (ELISA) in 40 HCC patients with AFP< 400ugl. (GI), 40 HCC patients with AFP> 400ugl.<br />(GII) and 20 healthy controls (GIII). Results: GPC-3 was found to be significantly elevated in HCC as compared to<br />healthy subjects (GI 38.2±22. 5, GII 50.2±22.6, and GIII 2.24±1.19), with sensitivities of 85% for GI and 84% for GII<br />and specificities of 95% for GI and 92% for GII. AFP showed respective sensitivities of 50% and 79%, and specificities<br />of 80% and 90%, for HCC diagnosis. The combination of GPC-3 with AFP achieved the highest sensitivity (98.5%) and<br />specificity (97.8%). Conclusion: Serum GPC-3 has a better sensitivity than AFP for the diagnosis of HCC. Combination<br />of two markers appears warranted for greatest accuracy