Résumé
Hepatocellular carcinoma [HCC] develops during the natural history of cirrhosis. HCC lesion of one cm in diameter with high or low echogenicity can be detected by ultrasonography and confirmed by needle biopsy. However, it is still very difficult to detect small isoechogenic HCC lesions, especially when AFP is normal. The serum level of alpha -L-fucosidase has been proposed as a marker of HCC. The aim of our study was to evaluate the serum alpha-L-fucosidase and alpha-fetoprotein levels in patients with liver cirrhosis and HCC. All patients were subjected to full history taking, clinical examination, laboratory investigations, abdominal ultrasonagraphy and ultrasongraphy guided percutaneous fine needle aspiration biopsy. To evaluate the role of serum alpha-L-fucosidase [AFU] in the diagnosis of hepatocellular carcinoma [HCC], we simultaneously studied both AFU activity and alpha-fetoprotein [AFP] levels in 40 patients with cirrhosis, 40 patients with HCC and 40 healthy subjects. Serum AFU activity in patients with HCC [573 +/- 210 nmol/ml/hr] and cirrhosis [285 +/- 143 nmol/ml/hr] was significantly higher than controls [216 +/- I l7nmol/ml/hr, p < 0.001]. With 450 nmol/ml/hr [mean value of controls plus 2 standard deviations] considered as the cut-off point, AFU was more sensitive [76 vs 65.4%] but less specific [90.9 vs 95.5%] than AFP at a level of> 400 ng/ml as a tumor marker of HCC. We conclude that AFU is a useful marker, in conjunction with AFP and ultrasonography, for detecting HCC