Role of serum glypican-3 in the diagnosis and differentiation of small hepatocellular carcinoma from hepatitis-C virus cirrhosis

Serum alpha-fetoprotein [AFP] has insufficient sensitivity and specificity for detection of hepatocellular carcinoma [HCC]. Recently, glypican-3 [GLP-3] was suggested as a new biomarker for the detection HCC. To determine the role of serum GLP-3 levels in the early diagnosis and differentiation of small [3 cm or less in diameter] HCC from liver cirrhosis. Also, to correlate GLP-3 levels to clinico-laboratory data. The study included sixty patients; 30 of them with hepatitis C virus [HCV] cirrhosis, and 30 patients with proved HCC. In addition, 20 healthy subjects were included as a control group. Clinical and radiological features [abdominal ultrasonography and/or abdominal triphasic computed tomography] were recorded. Liver function tests, complete blood cell count, and serum AFP were measured. Serum GLP-3 values were determined by an ELISA technique. Serum levels of GLP-3 were significantly elevated in patients with HCC compared with HCV cirrhosis group [p < 0.001]. Also, these levels were significantly elevated in these two patients' groups versus controls [p < 0.001]. Also; serum GLP-3 levels with cut-off value of >/= 240 ug/L, had a higher sensitivity [100%] and same specificity [93.3%], than AFP with cut-off value of >/= 200 ng/ ml, for detection of HCC. Moreover, GLP-3 levels showed a higher sensitivity than AFP [50% vs.41 .7%], for detection of small HCC. The combined use of both markers [i.e. when either one of the two markers positive] improved the specificity to 88.9%. Regarding unicentric HCC

Study of serum nitric oxide, soluble Fas and total sialic acid levels in patients with liver cirrhosis and their correlation with the stage and complications of the disease

Cirrhotic liver claims many lives in Egypt. Some factors may play a role in the pathogenesis of cirrhosis and its complications such as nitric oxide [NO] and soluble Fas [sFas]. However, others may be a consequence of liver damage as total sialic acid [TSA]. The aim of this study was to evaluate serum level of NO, sFas and TSA in patients with compensated and decompensated cirrhosis, with and without hepatitis C virus [HCV], and their correlation with the stage of the disease. The study included 34 patients with biopsy-proven cirrhosis [group I], categorized according to Child Pugh classification into three subgroups: group IA [11 patients with class A], group IB [13 patients with class B], and group IC [10 patients with class C], in addition to 15 age and sex matched healthy individuals as a control group [group II]. The mean age was 56.35 +/- 9.28 and 53 +/- 5.52 years, for group I and II, respectively. All studied individuals were subjected to full history taking, clinical examination, abdominal ultrasound, laboratory tests including liver function tests, hepatitis B surface antigen [HBsAg], hepatitis C virus antibodies [HCVAb], serum levels of NO, sFas and TSA. The study showed that, there was a significant increase in serum level of NO, TSA and sFas in cirrhotic patients group, when compared to the control group [P<0.001]. Serum NO and TSA levels were significantly increased with disease progression from grade A to grade B to grade C subgroups [P<0.001]. There was a significant increase of serum NO and TSA in cirrhotic patients with positive HCVAb, history of bleeding esophageal varices [O.V.], those with ascites, and those with spontaneous bacterial peritonitis [SBP], when compared with those with negative HCVAb, without bleeding O.V., without ascites, and without SBP, respectively. There was a positive correlation between serum NO and TSA with ALT [P<0.001] in cirrhotic patients subgroups, while there was no significant correlation as regards to sFas [P>0.05]. Serum NO is increased in patients with cirrhosis, particularly for those with positive HCVAb, and this increase is proportionate to the grade of cirrhosis. Understanding the role of NO in the pathophysiology of cirrhosis may help in initiating new lines of management. The increase of serum sFas in cirrhotic patients suggests the role of apoptosis in liver damage. Increased serum TSA in advanced cirrhosis, compared with early [Child's A] cirrhosis and controls, suggests that serum total sialic acid become a useful, non-invasive test, in the diagnosis and ftdlow up of cirrhosis

Oxidative stress and some antioxidant parameters in postmenopausal osteoporotic women with fractures a case control study

Osteoporosis is a major metabolic bone disease that occurs primarily in women over the age of 50 year because of the loss of estrogen during menopause. Oxidative stress plays an important role in the pathogenesis of postmenopausal osteoporosis [PMO]. Antioxidants, by virtue of their ability to mitigate the damaging effects of reactive oxygen species [ROS], have generated interest in their use as chemopreventive agents. The aim of this study was to evaluate the plasma levels of two selected antioxidant defenses [vit C and superoxide dismutase SOD] in addition to Malondialdehyde [MDA] levels, the byproduct of lipid peroxidation as an indicator of oxidative stress in postmenopausal osteoporotic women in comparison with non osteoporotic. Postmenopausal osteoporotic [n=40] and non osteoporotic [n=20] women as a control group aged from 45 years and above were included. All studied women were subjected to full history taking, clinical examination, and bone mineral density [BMD] measurements of the proximal femur using dual energy x-ray absorptiometry [DXA] scan and plasma levels of vit C, SOD and MDA were measured in all studied subjects. The study showed that women with PMO had significantly lower levels of plasma vit C and SOD and higher MDA levels in comparison to non osteoporotic control group [p < 0.05]. A significant positive correlation [p < 0.01] was found between plasma levels of vitamin C [r = 0.91], SOD [r =0.65] and Femoral neck BMD while a significant but negative correlation was found [r = -0.85, p <0.01] between MDA and femoral neck BMD among the studied subjects. It could be concluded that oxidative stress and decreased antioxidant defenses have an important role in the pathogenesis of postmenopausal osteoporosis and MDA, the oxidative stress marker may be an important indicator for bone loss in postmenopausal women. Further studies need to be carried out to investigate the exact rote of antioxidants in osteoporosis and their promising use as chemopreventive agents