ABSTRACT
The differential diagnostic utility of AFP, CEA, CA19.9 and TPA was evaluated in liver tumors. They were determined in the sera of 61 patients with primary hepatocellular carcinoma (HCC), 18 with secondary liver metastasis, 61 of benign liver cirrhosis in comparison to 20 normal healthy control subjects. The association of either HBV or HCV infection and HCC was also studied through the assay of HbSAg, HbSAb, and HCV-Ab. The optimal cut-off values were determined using the diagnostic accuracy measurements and the receiver operating characteristic (ROC) curves. AFP at an optimal cut-off value of 100 ng/ml and TPA at 160 U/L showed the highest sensitivity and specificity in detecting liver metastasis (100% and 87% for AFP; 100% and 54% for TPA respectively). The obtained data indicated that the combined assay of AFP and TPA resulted in a better discrimination of HCC among patients with hepatic focal lesions. HCV-Ab was detected in a higher ratio of HCC patients (83.6%) compared to HbsAg (68.9%), and both were detected in (34%) of HCC patients. This high incidence of HCV-Ab may suggest the implication of HCV in the molecular events leading to hepatic carcinogenesis.
Subject(s)
Biomarkers, Tumor/blood , Biomarkers/blood , Carcinoma, Hepatocellular/diagnosis , Hepatitis, Viral, Human/blood , Hepatitis, Viral, Human/diagnosis , Liver Neoplasms/blood , Liver Neoplasms/diagnosis , Adult , Aged , CA-19-9 Antigen/blood , Carcinoembryonic Antigen/blood , Carcinoma, Hepatocellular/blood , Diagnosis, Differential , Female , Hepatitis B Antibodies/blood , Hepatitis B Surface Antigens/blood , Hepatitis C Antibodies/blood , Humans , Liver Neoplasms/secondary , Male , Middle Aged , ROC Curve , Reference Values , Reproducibility of Results , Sensitivity and Specificity , Tissue Polypeptide Antigen/blood , alpha-Fetoproteins/analysisABSTRACT
From a panel of monoclonal antibodies (MAb), an IgM monoclonal antibody (7F1/6B) reactive with repetitive epitopes on S. mansoni soluble egg antigen was selected. This MAb was employed both as antigen capture and detection antibody in a sandwich ELISA and had a detection limit < 1 ng S. mansoni SEA/mi. Serum and urine samples were collected from rural students who had S. mansoni (169 subjects) or mixed S. mansoni and S. haematobium (64 subjects) infections. Samples were collected before and at 4, 8 and 12 weeks after praziquantel therapy. Circulating schistosome antigens (CSA) were demonstrated in 90% of sera and 97% of urine samples of S. mansoni group and in 91% of sera and 100% of urine samples of mixed infection group. All sera from 29 uninfected individuals, 30 patients with other parasites and 70% of 55 S. haematobium-infected subjects were negative in this assay. CSA level in serum and urine samples correlated positively with the number of S. mansoni eggs/g stool in both groups. A significant reduction in CSA level was observed in serum and urine samples after praziquantel therapy. By 12 weeks post-treatment, negativity was 98% in sera and 97% in urine of S. mansoni-infected group and 98% in sera and 91% in urine of mixed infection group. The data demonstrate that the use of MAb 7F1/6B for the detection of CSA provides a sensitive method for immunodiagnosis of schistosomiasis and monitoring of cure.
