Can we use GP73 as a biomarker for the detection of hepatocellular carcinoma?

Hepatocellular carcinoma [HCC] is one of the top five leading causes of death in Egypt and its prevalence is increasing in the next 10-20 years. We aimed to detect the serum Golgi protein 73 [GP73] in patients with cirrhosis and with HCC, and to determine its sensitivity and specificity as a screening tool for the detection of HCC in this study. Serum GP73 was estimated in 93 participants [patients with HCC, patients with cirrhosis, and healthy controls]. GP73 was elevated in patients with HCC and liver cirrhosis; serum level was very high in HCC patients [P<0.01] when compared with the other studied groups. GP73 had sensitivity of 76%, specificity of 75%, at a cut-off value of 16.2 ng/ml with area under the receiver operator characteristic of 0.825 when compared with alpha-fetoprotein that showed a sensitivity of 63%, specificity of 43% at a cut-off value of 16.5 ng/ml and area under the receiver operator characteristic of 0.611. By combining alpha-fetoprotein and GP73 for the diagnosis of HCC, sensitivity and specificity were [93 and 25%], respectively. There is a significant positive correlation between diameter of the focal lesion and GP73 [P=0.01 and r=0.071]. Nonsignificant positive correlation was detected as regards serum GP73 and the number of HCC. GP73 can be used as a screening tool for the detection of HCC. Moreover, it shows a higher serum level with larger lesions

Long-term effect of argon plasma coagulation [APC] in the treatment of gastric antral vascular ectasia [GAVE]

Gastric antral vascular ectasia [GAVE] is a distinct vascular abnormality, mainly involving the gastric antrum. It is a rare but well-known cause of occult gastrointestinal bleeding. Various endoscopic treatment modalities have been tried in this condition. The aim of the study is to show the long-term effect of argon plasma coagulation [APC] on GAVE. Twenty-nine patients with endoscopically proved GAVE were enrolled in the study. Clinical assessment of GAVE patients, haemoglobin [Hb] level and transfused blood units were recorded after APC using 60-80-W power setting. A second session was done 1 month after the therapeutic procedure to ensure complete ablation of all lesions. The documented Hb levels and number of blood units transfused 3 months after APC were recorded. At endoscopy, all patients had the classic type of GAVE. The mean Hb level increased from 7.5 +/- 1.7 g dl[-1] before APC to 10.2 +/- 0.8 g dl[-1] after APC [p value <0.001]. The transfusion requirements significantly decreased to 0.2 +/- 0.5 units/patient [p value <0.001]. Endoscopic APC is a safe, effective and inexpensive modality in treating GAVE and could be an alternative to the currently available endoscopic methods