Efficacy of percuatneous radiofrequency ablation in the management of hepatocellular carcinoma with schistosomisis

Radiofrequency ablation [RFA] is a well known therapeutic modality in the curative treatment of hepatocellular carcinoma [HCC]. The aim of this work was to assess the efficacy of percutaneous RFA in patients with tumors 400 ng/ml] and/or typical pattern of triphasic CT examination. RFA was employed to all patients. Triphasic CT examination was performed 1 month after the end of procedure and at three months interval for one year of follow up. Ultrasound examination and AFP were performed at 3 months interval for the same follow up period. Recurrence was considered when typical criteria were detected at triphasic CT examination. The results showed that full necrosis of the tumor was achieved in 42 patients in group I [93.3%] and in 41 patients in group II [93.18%]; [P>0.05]]. Recurrence after 1 year was detected in 11 patients of group I [26.19%] and 12 patients of group II [29.27%], [P> 0.05]

Clinical role of serum squamous cell carcinoma antigen in egyptian patients with hepatocellular carcinoma

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