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
Subject(s)
Humans , Male , Female , Carcinoma, Squamous Cell , /blood , /blood , alpha-Fetoproteins/blood , Tomography, X-Ray ComputedABSTRACT
Intercellular adhesion molecule-1 [ICAM-1] plays a fundamental role during liver inflammation. In fact, weak ICAM-1 expression is physiologically restricted to the endothelium of portal vessels and to sinusoidal lining cells, but it becomes markedly evident on sinusoidal lining cells and at the surface of hepatocytes during inflammatory liver diseases. The aim of this study was to evaluate the level of soluble ICAM-1 [sICAM-1] in chronic hepatitis C [CHC] patients and its changes during interferon [IFN] therapy. Sixty subjects were divided into 2 groups: group A included 40 patients with CHC [subdivided according to their response to treatment into responders and non-responders] and group B included 20 healthy subjects representing the control group. Levels of sICAM-1 were measured in 40 patients with CHC treated with IFN and ribavarin, at baseline and after 3 months of therapy, and in 20 normal control subjects. All the patients were negative for HBV surface antigen. All the controls were negative for HBV surface antigen, and HCV antibody. The levels of sICAM-1 were significantly higher in the patient than in the control subject group [3.40 +/- 1.44 micro g/Lvs. 1.91 +/- 0.34/ micro g/L; p<.001]. Baseline sICAM-1 levels were similar in responders and non-responders [3.58 +/- 1.8 micro g/L vs. 3.24 +/- 1.04 micro g/L; P. NS]. By contrast, the concentration of sICAM-1 decreased significantly only in responders after 3 months of therapy [3.58 +/- 1.87 micro g/L vs.2.50 +/- 0.59 micro g/L; P<.001] and not in non-responders [3.24 +/- 1.04 micro g/L vs. 3.12 +/- 1.02 Pg/L; P. NS]. The probability of response to treatment, analyzed by Kaplan-Meier analysis, was much higher in the group showing a decrease of sICAM-1 than in the patients who did not show such a decrease. In conclusion, a longitudinal evaluation of serum levels of sICAM-1 in the first period of treatment is particularly useful in the identification of patients with high significant probability of response to treatment