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