ABSTRACT
Background@#Lymphoproliferative disorders (LPDs) are a heterogeneous group of diseases characterized by an uncontrolled production of monoclonal lymphocytes. RECAF is the receptor for alpha-fetoprotein, which is re-expressed on malignant cells, thus serving as a broad-spectrum tumor marker. @*Methods@#The current study is a retrospective study carried out on 200 archival bone marrow trephine biopsy specimens [60 normal control (NC), 38 pathological control (PC) and 102 lymphoproliferative diseases (LPD) specimens]. RECAF expression was assessed using immunohistochemistry. @*Results@#The percentage of cells that are positive for RECAF was significantly higher in the LPD group than in the NC group (P=0.007), while there was no significant difference between non-Hodgkin lymphoma (NHL) patients and PC regarding the number of RECAF positive cells (P=0.1). RECAF showed a unique expression pattern among the different subtypes of LPD. None of the hairy cell leukemia (HCL) expressed RECAF, while the highest percentage was seen in follicular lymphoma (FL) and diffuse large B cell lymphoma (DLBCL) (P=0.001). Compared to routine histopathology, RECAF was more sensitive in detecting bone marrow (BM) infiltration in FL, mantle cell lymphoma (MCL), and DLBCL (P=0.01). @*Conclusion@#RECAF is significantly expressed in the BM of NHL/chronic lymphocytic leukemia (CLL) patients. RECAF shows a unique expression pattern among the different subtypes of LPD.Furthermore, RECAF may help to detect bone marrow infiltration in lymphoma cells. This may help in the diagnosis, follow-up, and targeting of LPD.
ABSTRACT
Background@#Lymphoproliferative disorders (LPDs) are a heterogeneous group of diseases characterized by an uncontrolled production of monoclonal lymphocytes. RECAF is the receptor for alpha-fetoprotein, which is re-expressed on malignant cells, thus serving as a broad-spectrum tumor marker. @*Methods@#The current study is a retrospective study carried out on 200 archival bone marrow trephine biopsy specimens [60 normal control (NC), 38 pathological control (PC) and 102 lymphoproliferative diseases (LPD) specimens]. RECAF expression was assessed using immunohistochemistry. @*Results@#The percentage of cells that are positive for RECAF was significantly higher in the LPD group than in the NC group (P=0.007), while there was no significant difference between non-Hodgkin lymphoma (NHL) patients and PC regarding the number of RECAF positive cells (P=0.1). RECAF showed a unique expression pattern among the different subtypes of LPD. None of the hairy cell leukemia (HCL) expressed RECAF, while the highest percentage was seen in follicular lymphoma (FL) and diffuse large B cell lymphoma (DLBCL) (P=0.001). Compared to routine histopathology, RECAF was more sensitive in detecting bone marrow (BM) infiltration in FL, mantle cell lymphoma (MCL), and DLBCL (P=0.01). @*Conclusion@#RECAF is significantly expressed in the BM of NHL/chronic lymphocytic leukemia (CLL) patients. RECAF shows a unique expression pattern among the different subtypes of LPD.Furthermore, RECAF may help to detect bone marrow infiltration in lymphoma cells. This may help in the diagnosis, follow-up, and targeting of LPD.
ABSTRACT
Since major advances in our ability to treat hepatocellular carcinoma [HCC] are less likely to come from treating late stage disease it is therefore important to find early stage disease. Serum Alpha-fetoprotein [alpha - FP] is currently the most widely performed screening test, but this sensitivity poor. It has been reported, recently, that squamous cell carcinoma antigen [SCCA] could represent a useful screening marker in patients at risk. The aim of this study to investigate the diagnostic utility of serum SCCA as a non invasive marker in HCC patients compared to alpha-FP. We recruited for the study forty patients with HCC, 25 patients with liver cirrhosis and 15 healthy subjects. Serum levels of SCCA and alpha-FP together with clinical, laboratory, and imaging evaluation were done for all cases. Hepatic focal lesions with atypical CT pattern for HCC were confirmed histopathologically with ultrasound-guided biopsy. Mean values of serum SCCA in HCC group was significantly higher when compared with both the control and cirrhotic groups [p<0.001]. It was significantly elevated in HCC patients showing atypical enhancement pattern versus those with typical one [p<0.05]. At the value of the kit cutoff value [2 ug/l], the specificity and sensitivity of SCCA were 62% and 84% respectively. While when using the receiver operator curve [ROC] curve, to improve the specificity and sensitivity of SCCA, the cutoff value of 2.55 ug/l yielded a sensitivity and specificity of 52.5% and 96% respectively [best cutoff]. The diagnostic sensitivity of alpha-FP at a cutoff 200 ng/dl was 26% and the specificity 100%. The cutoff level of alpha-FP for diagnosis of HCC according to ROC was 91.5 ng/dl yielded a sensitivity and specificity of 62.5% and 92%, respectively [best cutoff]. Simultaneous measurement of alpha-FP and SCCA led to improve the sensitivity of serologic diagnosis of HCC up to 87.5%. SCCA represents a useful diagnostic biomarker for HCC detection, when combined with alpha-FP, it significantly increases the reliability of serologic diagnosis for this cancer. SCCA could specially diagnose those with atypical enhancement pattern in CT scan