ABSTRACT
Hepatocellular carcinoma [HCC] is a common malignancy over the world and Egypt, specially related to viral [B, C] hepatitis and cirrhosis. In many patients, imaging radiology is not conclusive in diagnosis of HCC, so tumor markers may help to solve the problem. Alpha fetoprotein [AFP] and Carbohydrate antigen 19-9 [CA 19-9] are used in this situation. This study was done on 60 patients divided into 2 groups: group I; 30 patients with HCC and group II: 30 patients with chronic liver diseases with or without cirrhosis. The results were: demographic case distribution; HCC is still of old age group [>52 years], more in males [70%] than in females [30%], farmers [40%] more than other jobs, rural population [60%] than urban [40%], related to HCV infection [96%] and HBV infection [23%]. AFP and CA 19-9 were highly significant in serum of HCC group than group II. There was no correlation between the level of both AFP and CA19-9 and biochemical liver tests, number or size of the tumor. But there is high correlation with histopathology of the tumor. By using ROC curve, the best cut-off of AFP is 25 ng/ml with a sensitivity and specificity of 86.7%, and for CA19-9, it was 97 u/ml with a sensitivity of 53.3% and specificity of 86.7%. CA19-9 enhance AFP in diagnosis of HCC in 30% of cases. So, using CA19-9 in combination with APP can increase diagnosis of HCC in hepatic focal lesion by 30%. But, we still need other sensitive and specific non invasive technique for diagnosis of HCC