ABSTRACT
Hepatocellular carcinoma [HCC] is one of the most common malignant tumors. HCC occurs mainly in patients with chronic liver disease such as in hepatitis B and C infection. HCC lesion of one cm in diameter with high or low echogenicity can be detected by ultrasonography and confirmed by liver needle biopsy, however, it is still very difficult to detect small isoechogenic HCC lesions especially when a-fetoprotein [AFP] is normal. The serum level of Glypican-3 [GPC-3] has been reported as a marker of HCC. The aim of our study was to evaluate the diagnostic value of serum [GPC-3] and a-AFP in patients with liver cirrhosis and HCC. All patients were subjected to full history taking, clinical examination, laboratory investigations, abdominal ultrasonography and ultrasonography guided percutaneous liver needle biopsy. To evaluate the role of [GPC-3] in the diagnosis of HCC, we simultaneously studied serum [GPC-3] and [AFP] levels in 40 patients with cirrhosis, 40 patients with HCC and 40 healthy subjects as a control. Serum [GPC-3] in patients with HCC [563 +/- 220ng/ml] and in cirrhotic patients [275 +/- 153 ng/ml] was significantly higher than control [206 +/- 127 mg/ml p<0.001] with 300 ng/ml [mean value of controls plus 2 standard deviations] considered as the cut-off point. [GPC-3] was more sensitive [86 vs 65%] but less specific [80.5 vs 90.9%] than [AFP] at level of > 400 ng/ml as a tumour marker of HCC. We conclude that [GPC-3] is useful marker, in conjunction with [AFP] and liver ultrasonography for detecting HCC